Individual
MRS. JESSICA ELIZABETH HANDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
425 SUMMIT ST, WILD ROSE, WI 54984-6804
(920) 622-4342
Mailing address
425 SUMMIT ST, WILD ROSE, WI 54984-6804
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5005
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649264623
—
WI
Enumeration date
11/25/2017
Last updated
11/25/2017
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