Individual
MS. THERESA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
8633 32ND AVE, KENOSHA, WI 53142-5187
(262) 694-8800
(262) 694-9125
Mailing address
8633 32ND AVE, KENOSHA, WI 53142-5187
(262) 694-8800
(262) 694-9125
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5234-26
WI
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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