Individual
MRS. REBECCA PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,OTR
Contact information
Practice address
N2220 BEAN CITY ROAD, NEW LONDON, WI 54961-8737
(920) 982-1464
Mailing address
N2220 BEAN CITY ROAD, NEW LONDON, WI 54961-8737
(920) 982-1464
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1648-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40620700
—
WI
Enumeration date
02/22/2007
Last updated
07/08/2007
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