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Individual

VICKI J. MOILANEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.R.

Contact information

Practice address
N84W16889 MENOMONEE AVE, MENOMONEE FALLS, WI 53051-2810
(262) 251-7500
(262) 251-7128
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 251-7500

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1199
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40825800
WI
01
P00836833
RR MEDICARE
WI
Enumeration date
07/04/2006
Last updated
10/15/2023
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