Individual
MRS. MARY ANN HALBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1610 HOOVER ST, NEW HOLSTEIN, WI 53061-1636
(920) 898-5627
(920) 898-1375
Mailing address
1610 HOOVER ST, NEW HOLSTEIN, WI 53061-1636
(920) 898-5627
(920) 898-1375
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
937-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40736600
—
WI
Enumeration date
05/04/2007
Last updated
07/08/2007
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