Individual
CARLY ERICSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1000 N 92ND ST, MILWAUKEE, WI 53226-3533
(414) 259-0575
Mailing address
1000 N 92ND ST, MILWAUKEE, WI 53226-3533
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
05/17/2017
Last updated
05/31/2017
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