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Individual

MS. SUSAN JOAN KNUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L, ATP

Contact information

Practice address
1800 APPLETON RD, EARLY INTERVENTION SERVICES, MENASHA, WI 54952-3727
(920) 968-6236
Mailing address
414 WASHINGTON AVE, NEENAH, WI 54956-3341
(920) 729-5658

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1625-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1625-26
STATE OF WISCONSIN DEPT OF REGULATION AND LICENSING
WI
01
808
WISCONSIN DEPARTMENT OF PUBLIC INSTRUCTION - EARLY CHILDHOOD EXCEPTIONAL ED NEED
WI
01
812
WISCONSIN DEPARTMENT OF PUBLIC INSTRUCTION - OCCUPATIONAL THERAPY
WI
Enumeration date
12/08/2011
Last updated
12/08/2011
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