Individual
LAUREN FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 W HONADEL BLVD, OAK CREEK, WI 53154-2650
(414) 435-2005
Mailing address
2700 W HONADEL BLVD, OAK CREEK, WI 53154-2650
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
668526
WI
Other
Enumeration date
04/07/2020
Last updated
08/21/2022
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