Individual
JOANNE RITA NIEMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1625 E MAIN ST, CLINTONVILLE, WI 54929-8407
(715) 823-3135
Mailing address
1625 E MAIN ST, CLINTONVILLE, WI 54929-8407
(715) 823-3135
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
476-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40692900
—
WI
Enumeration date
11/11/2008
Last updated
11/11/2008
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