Individual
SUSAN ELAINE REICHENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
W231S7680 BIG BEND DR, BIG BEND, WI 53103-9686
(262) 662-9760
(262) 662-9761
Mailing address
N26W26210 QUAIL HOLLOW RD, #1, PEWAUKEE, WI 53072-4547
(262) 695-0397
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4158026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40876600
—
WI
01
—
4158026
STATE OF WI OT LICENSE #
WI
Enumeration date
12/27/2006
Last updated
07/08/2007
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