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Individual

MRS. MARY JO HUBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
S4555 HWY CH, REEDSBURG, WI 53959-9511
(608) 524-7511
(608) 524-7599
Mailing address
S4555 HWY CH, REEDSBURG, WI 53959-9511
(608) 524-7511
(608) 524-7599

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
241027
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2410Z7
STATE OF WIS DEPT OF REGULATION AND LICENSING
WI
05
4066Z700
WI
01
AA532887
NATIONAL BOARD FOR CERTIFICATION IN OCUPATIONAL THERAPY INC
Enumeration date
05/14/2008
Last updated
05/14/2008
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