Individual
YVONNE VANDER HEIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2121 S ONEIDA ST, GREEN BAY, WI 54304-4617
(920) 209-0012
Mailing address
121 W TOWN RD, PULASKI, WI 54162-9278
(920) 209-0012
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.004262
IL
224Z00000X
Occupational Therapy Assistant
Primary
5161-27
WI
Other
Enumeration date
09/15/2015
Last updated
12/12/2022
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