Individual
JANE AYRE LOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
611 N SAINT JOSEPH AVE, MARSHFIELD, WI 54449-1832
(715) 387-9562
Mailing address
611 N SAINT JOSEPH AVE, MARSHFIELD, WI 54449-1832
(715) 387-9562
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5115-26
WI
225XM0800X
Mental Health Occupational Therapist
101773
MN
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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