Individual
HEATHER PAULSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
820 YOUNG ST, WAUSAU, WI 54403-6451
(715) 419-0548
Mailing address
820 YOUNG ST, WAUSAU, WI 54403-6451
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
073777
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100042758
—
WI
Enumeration date
05/28/2014
Last updated
06/30/2015
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