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Individual

RUTH MARIE BOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
244 NORTH MACY STREET, FOND DU LAC, WI 54935
(920) 921-9520
(920) 924-7859
Mailing address
244 NORTH MACY STREET, FOND DU LAC, WI 54935
(920) 921-9520
(920) 921-0819

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
522-027

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20129000
WI
Enumeration date
06/04/2010
Last updated
06/04/2010
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