Individual
MS. CARINA LEA HAFNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3301 CRANBERRY BLVD, WESTON, WI 54476-5216
(715) 393-3990
(715) 393-3902
Mailing address
3301 CRANBERRY BLVD, WESTON, WI 54476-5216
(715) 393-3990
(715) 393-3902
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5301-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301-26
WI STATE LICENSE
WI
Enumeration date
10/30/2013
Last updated
10/30/2013
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