Individual
RONNETTE L WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
220 KELLER AVE N, AMERY, WI 54001-1036
(715) 268-1008
Mailing address
220 KELLER AVE N, AMERY, WI 54001-1036
(715) 268-1008
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1551-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093763518
ARMC
WI
01
—
1551-27
WISCONSIN LICENSE
WI
Enumeration date
01/11/2008
Last updated
01/11/2008
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