Individual
MELANIE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 W ANN ST, KAUKAUNA, WI 54130-3882
(920) 515-2472
Mailing address
1312 W ANN ST, KAUKAUNA, WI 54130-3882
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5560
WI
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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