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Individual

SALLY B MERGENDAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
5412 US HIGHWAY 10 E, STEVENS POINT, WI 54482-8559
(715) 346-5243
Mailing address
5412 US HIGHWAY 10 E, STEVENS POINT, WI 54482-8559
(715) 346-5243

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
417-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
417-26
WI STATE LIC
WI
Enumeration date
03/15/2012
Last updated
03/15/2012
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