Individual
MS. MARY J. FARNER-OREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
11 BLANCHARD ST, EDGERTON, WI 53534-1501
(608) 884-8831
Mailing address
11 BLANCHARD ST, EDGERTON, WI 53534-1501
(608) 884-8831
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
404-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
404-027
STATE LICIENCE
WI
Enumeration date
03/13/2007
Last updated
07/08/2007
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