Individual
KATELIN NOLAN MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 BROADWAY ST # 480, BARABOO, WI 53913-2183
(608) 355-4200
Mailing address
210 ASH ST APT 2, SAUK CITY, WI 53583-1080
(608) 604-4040
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6638026
WI
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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