Individual
JENNIFER NINA MAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2705 ENLOE ST, HUDSON, WI 54016-8173
(715) 386-2128
Mailing address
180 S PLUM ST, ELLSWORTH, WI 54011-4137
(715) 497-3277
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3526
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40837400
—
WI
01
—
6401859
MEDICA
—
01
—
641671046996
PREFERRED ONE
—
01
—
7847436
AETNA
—
01
—
98G89GE
BCBS MN
MN
01
—
HP43827
HEALTH PARTNERS
—
Enumeration date
12/28/2006
Last updated
07/09/2007
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