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Individual

MRS. JENNIFER M CAREW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
930 N 6TH ST, SHEBOYGAN, WI 53081-4150
(920) 458-2137
Mailing address
930 N 6TH ST, SHEBOYGAN, WI 53081-4150
(920) 458-2137

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
806027
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40900300
WI
01
806027
STATE LICENSING
WI
Enumeration date
04/22/2008
Last updated
04/22/2008
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