Individual
MS. LAURA LEE CHRISTINE GANSKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A
Contact information
Practice address
2915 N MEADE ST, APPLETON, WI 54911-1509
(920) 993-6800
Mailing address
2915 N MEADE ST,, APPLETON, WI 54911
(920) 993-6800
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.003319
IL
224Z00000X
Occupational Therapy Assistant
Primary
4783-27
WI
Other
Enumeration date
01/09/2011
Last updated
12/11/2015
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