Individual
MARY B. KEVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
13111 N. PORT WASHINGTON RD, MEQUON, WI 53092
(262) 243-7444
Mailing address
N88W6278 WILLOWBROOKE DR, CEDARBURG, WI 53012-1346
(262) 573-3867
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2024026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40729800
—
WI
Enumeration date
06/08/2006
Last updated
07/09/2007
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