Individual
JENELLE PELOQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 BIRCH ST, BALDWIN, WI 54002-9348
(715) 688-2506
Mailing address
650 BIRCH ST, BALDWIN, WI 54002-9348
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
202092
MN
224Z00000X
Occupational Therapy Assistant
Primary
5244-27
WI
Other
Enumeration date
01/21/2016
Last updated
01/21/2016
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