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Individual

KASSI EVELYN OLERUD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS/OTR

Contact information

Practice address
E7404A COUNTY ROAD BB, VIROQUA, WI 54665-7502
(608) 637-5422
Mailing address
707 PINE PLACE, WESTBY, WI 54667
(608) 790-6640

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5131-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1265798995
WI
05
22
WI
Enumeration date
04/06/2012
Last updated
03/17/2018
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