Individual
JUDY GUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3821 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3600
(920) 208-6316
Mailing address
3821 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3600
(920) 208-6316
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5825-26
WI
225XP0200X
Pediatric Occupational Therapist
Primary
5825-26
WI
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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