Individual
MISS TATUM NEHLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5321 DOUGLAS AVE, CALEDONIA, WI 53402-5800
(262) 804-8094
Mailing address
5321 DOUGLAS AVE, CALEDONIA, WI 53402-5800
(262) 804-8094
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
708627
WI
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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