Individual
BONNIE M LANCOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3415 SHERIDAN RD, KENOSHA, WI 53140-1924
(262) 653-2954
Mailing address
375 E GOLDEN LN, OAK CREEK, WI 53154-4509
(262) 470-2557
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4694-027
WI
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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