Individual
EMMA JEAN DEDERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1414 JEFFERSON ST, BARABOO, WI 53913-1503
(608) 356-1400
Mailing address
1414 JEFFERSON ST, BARABOO, WI 53913-1503
(608) 356-1400
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5172-26
WI
Other
Enumeration date
06/11/2012
Last updated
06/11/2012
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