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Individual

MS. SUZETTE A RAES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2990 CAHILL MAIN, FITCHBURG, WI 53711-7130
(608) 204-6083
Mailing address
519 RUPERT RD, WAUNAKEE, WI 53597-1586
(608) 849-7582

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3297-026
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1034545
NATIONAL CERTIFICATION NUMBER
01
3297-026
STATE OT LICENSE NUMBER
WI
Enumeration date
01/05/2010
Last updated
01/05/2010
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