Individual
MICHELLE HALSTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
Mailing address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40803200
—
WI
Enumeration date
12/15/2006
Last updated
07/08/2007
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