Individual
MALISSA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1070 S LAKE SHORE DR, UNIT 5-2A, LAKE GENEVA, WI 53147-2256
(262) 496-5477
Mailing address
1070 S LAKE SHORE DR, UNIT 5-2A, LAKE GENEVA, WI 53147-2256
(262) 496-5477
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5887-26
WI
Other
Enumeration date
06/11/2016
Last updated
06/11/2016
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