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Individual

MRS. ALYSSA BETH WIENKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2990 RAFFEL RD, WOODSTOCK, IL 60098-8466
(815) 338-8200
Mailing address
PO BOX 361, HAMPSHIRE, IL 60140-0361
(847) 417-0386

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013036
IL
225X00000X
Occupational Therapist
7389
AZ

Other

Enumeration date
02/22/2018
Last updated
05/27/2020
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