Individual
MRS. PAIGE ALEXIS GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5055
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8009-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8009-26
WISCONSIN OCCUPATIONAL THERAPY LICENSE
WI
Enumeration date
08/01/2022
Last updated
10/08/2024
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