Individual
JENNIFER NEISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1700 C A BECKER DR, RACINE, WI 53406-4714
(262) 898-2804
Mailing address
1700 C A BECKER DR, RACINE, WI 53406-4714
(262) 898-2804
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5130-27
WI
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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