Individual
MRS. CARISSA A SOMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 457-4461
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6492
WI
225XP0200X
Pediatric Occupational Therapist
6492-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102629
—
WI
01
—
6492-26
WI OTR/L LICENSE NUMBER
—
Enumeration date
04/30/2019
Last updated
07/25/2023
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