Individual
VICKI SUE KAMUCHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-5299
Mailing address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1042-27
WI
Other
Enumeration date
09/15/2017
Last updated
09/15/2017
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