Individual
JUDITH LORRAINE SOUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2705 ENLOE ST, HUDSON, WI 54016-8173
(715) 386-2128
(715) 386-6119
Mailing address
1511 BRANSTON ST, SAINT PAUL, MN 55108-1437
(651) 644-4086
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4141
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40872200
—
WI
01
—
6404305
MEDICA
—
01
—
641671046996
PREFERRED ONE
—
01
—
7689529
AETNA
—
01
—
98G59SO
BCBS MN
—
01
—
HP43837
HEALTH PARTNERS
—
Enumeration date
03/16/2007
Last updated
07/09/2007
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