Individual
TERESA M VANLANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
575 4TH ST, KEWAUNEE, WI 54216-1785
(920) 388-4640
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4108
LICENSE
WI
Enumeration date
11/10/2006
Last updated
07/08/2007
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