Individual
BRIANA ANN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
614 S ROCK AVE, VIROQUA, WI 54665
(608) 637-6337
Mailing address
17794 COUNTY HIGHWAY A, NORWALK, WI 54648-7022
(608) 343-3084
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5312-17
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467901389
—
WI
Enumeration date
10/04/2016
Last updated
06/05/2019
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