Individual
MRS. SARA LYNN WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
(920) 568-6545
Mailing address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
(920) 568-6545
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
4510-026
WI
225X00000X
Occupational Therapist
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41046300
—
WI
Enumeration date
07/31/2007
Last updated
12/07/2015
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