Individual
MANDY M PLOEDERL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
960 S RAPIDS RD, MANITOWOC, WI 54220-4146
(920) 684-1144
Mailing address
960 S RAPIDS RD, MANITOWOC, WI 54220-4146
(920) 684-1144
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4582-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41058900
—
WI
Enumeration date
05/15/2008
Last updated
05/15/2008
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