Individual
ANNALISE GRACE SPLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1142 ORLANDO DR, DE PERE, WI 54115-9484
(920) 339-0700
Mailing address
1142 ORLANDO DR, DE PERE, WI 54115-9484
(920) 339-0700
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5873-27
WI
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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