Individual
KATHLEEN M SHANOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2927 S FISH HATCHERY RD, FITCHBURG, WI 53711-6498
(608) 819-6394
Mailing address
2927 S FISH HATCHERY RD, FITCHBURG, WI 53711-6498
(608) 819-6394
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6358-26
WI
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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