Individual
MS. CARRIE ANN JENNERJOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
120 E NATIONAL AVE, APT 105, MILWAUKEE, WI 53204-1879
(414) 416-0148
Mailing address
120 E NATIONAL AVE, APT 105, MILWAUKEE, WI 53204-1879
(414) 416-0148
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5174-26
WI
Other
Enumeration date
04/12/2012
Last updated
04/12/2012
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