Individual
AMANDA M WALESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA, CLT
Contact information
Practice address
2629 N 7TH ST, SHEBOYGAN, WI 53083-4932
(920) 551-5550
Mailing address
2121 ILLINOIS AVE, NEW HOLSTEIN, WI 53061-1210
(920) 579-0879
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
5310
WI
224Z00000X
Occupational Therapy Assistant
Primary
5310-27
WI
Other
Enumeration date
08/02/2017
Last updated
08/02/2017
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