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Individual

TRYN A GASIOROWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
N112W17975 MEQUON RD, GERMANTOWN, WI 53022-2425
(262) 532-7600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7227-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100199244
WI
01
467984
NBCOT CERTIFICATION ID
WI
01
7227-26
DSPS WISCONSIN STATE OT LICENSE
WI
Enumeration date
04/22/2022
Last updated
04/25/2025
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