Individual
MISTY M CARRIVEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8000
Mailing address
W 7061 OLD W ROAD, PO BOX 414, CRIVITZ, WI 54114
(715) 854-8294
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3734
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40840700
—
WI
Enumeration date
03/12/2007
Last updated
09/19/2024
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