Individual
AMY JO FOLKESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
35 N 28TH ST, SUPERIOR, WI 54880-5557
(715) 392-3300
Mailing address
35 N 28TH ST, SUPERIOR, WI 54880-5557
(715) 392-3300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1893-27
WI
224Z00000X
Occupational Therapy Assistant
200330
MN
Other
Enumeration date
11/23/2012
Last updated
11/23/2012
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