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Individual

MRS. KRISTYN NICOLE SANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
960 S RAPIDS RD, MANITOWOC, WI 54220-4146
(920) 684-1144
Mailing address
2610 RIVERSIDE DR, GREEN BAY, WI 54301-2940
(920) 676-2933

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
1925027
WI
225X00000X
Occupational Therapist
Primary
5378-26
WI

Other

Enumeration date
08/06/2007
Last updated
02/11/2014
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