Individual
MRS. JUDITH LYNN FECTEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
9449 W FOREST HOME AVE, HALES CORNERS CARE CENTER REHAB DEPT., HALES CORNERS, WI 53130-1611
(414) 529-1271
(414) 529-1271
Mailing address
9449 W FOREST HOME AVE, HALES CORNERS CARE CENTER REHAB DEPT., HALES CORNERS, WI 53130-1611
(414) 529-1271
(414) 529-1271
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
861-26
WI
225X00000X
Occupational Therapist
861026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40524200
—
WI
Enumeration date
05/06/2008
Last updated
03/06/2014
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