Organization
WESTERN WISCONSIN MUSIC IN MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY NEGUS COTA-NMT/L (DIRECTOR)
(715) 495-3768
Entity
Organization
Contact information
Practice address
S806 COUNTY ROAD H, MONDOVI, WI 54755-8210
(715) 495-3768
(715) 926-5137
Mailing address
S 806 COUTY ROAD H, MONDOVI, WI 54755-8210
(715) 495-3768
(715) 926-5137
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
1617-27
WI
225A00000X
Music Therapist
28038
WI
225X00000X
Occupational Therapist
Primary
2363-26
WI
235Z00000X
Speech-Language Pathologist
718241
WI
Other
Enumeration date
08/02/2010
Last updated
01/06/2011
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