Individual
MICHELLE L MAZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
545 E MAIN ST STE B, LANDER, WY 82520-3470
(307) 335-3471
(307) 332-5388
Mailing address
PO BOX 625, LANDER, WY 82520-0625
(307) 335-3471
(307) 332-5388
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT814
WY
225XP0019X
Physical Rehabilitation Occupational Therapist
OT-814
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0218062
DEPT. OF LABOR & INDUSTRY
WA
01
—
5245MA
REGENCE BLUE SHIELD
WA
01
—
8950731
L&I CRIME
WA
Enumeration date
02/16/2007
Last updated
04/07/2025
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