Individual
MS. SUE LAURIE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1401 CHURCHILL ST, WAUPACA, WI 54981-2027
(715) 258-8131
(715) 258-0179
Mailing address
N6136 GARRITY RD, MANAWA, WI 54949-8819
(920) 596-3723
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2263-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40821600
—
WI
Enumeration date
05/07/2007
Last updated
07/08/2007
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