Individual
MRS. MARCIE MARIE WENZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
700 CLARK ST, LODI, WI 53555-1010
(608) 592-3241
Mailing address
W10633 CASCADE MOUNTAIN RD, PORTAGE, WI 53901-9631
(608) 742-0441
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1349027
WI
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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