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Individual

MRS. STELLA D. KAAS-LALLENSACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
W5774 GARTON RD, PLYMOUTH, WI 53073
(920) 876-2521
(920) 849-1811
Mailing address
W5774 GARTON RD, PLYMOUTH, WI 53073-2849
(920) 876-2521
(920) 849-1811

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
815-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40676400
WI
Enumeration date
08/26/2008
Last updated
08/26/2008
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