Individual
MRS. LAURIE LYNN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2801 S WEBSTER AVE, GREEN BAY, WI 54301-2878
(920) 337-1122
(920) 337-1126
Mailing address
1731 EMERALD DR, GREEN BAY, WI 54311-5046
(920) 676-4916
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1243-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41810300
—
WI
Enumeration date
06/20/2007
Last updated
01/09/2018
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