Individual
KAYLA MARTHA HENKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1040 PILGRIM WAY, GREEN BAY, WI 54304-5028
(920) 405-3522
Mailing address
1291 LAKEVIEW LN, MENASHA, WI 54952-1327
(920) 428-1260
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
470327
WI
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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