Individual
SALLY K POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3402 HOWLAND AVE, SUITE 100, WESTON, WI 54476-5633
(715) 355-5701
Mailing address
3000 WESTHILL DR, SUITE 303, WAUSAU, WI 54401-3795
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2418-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40885800
—
WI
Enumeration date
08/29/2006
Last updated
07/09/2007
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