Individual
HOLLY MARIE PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
742 STERBENZ DR, AVANTI CENTER INC, HUDSON, WI 54016-8327
(715) 386-2128
(715) 386-6119
Mailing address
742 STERBENZ DR, AVANTI CENTER INC, HUDSON, WI 54016-8327
(715) 386-2128
(715) 386-6119
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
103591
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4928
LICENSE NUMBER
WI
Enumeration date
05/22/2008
Last updated
04/08/2011
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