Individual
MARY ANN B ROELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR
Contact information
Practice address
1414 S PARK ST, MADISON, WI 53715-2106
(608) 417-8250
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-8250
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1127-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40713100
—
WI
Enumeration date
12/11/2006
Last updated
03/13/2024
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