Individual
JENNA BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
N9437 SARA LN, APPLETON, WI 54915-5206
(920) 277-0531
Mailing address
N9437 SARA LN, APPLETON, WI 54915-5206
(920) 277-0531
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5260-27
WI
Other
Enumeration date
08/07/2016
Last updated
08/07/2016
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