Individual
SUZANNE M WEIGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3305 N BALLARD RD STE C, APPLETON, WI 54911-9001
(920) 735-9234
Mailing address
514 DESNOYER ST, KAUKAUNA, WI 54130-2010
(920) 858-6168
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4577-027
WI
Other
Enumeration date
10/12/2009
Last updated
10/19/2009
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