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Individual

MRS. JENNIFER LYNN KITELINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
311 REAUME AVE, KAUKAUNA, WI 54130-2430
(920) 205-5727
(920) 759-1937
Mailing address
311 REAUME AVE, KAUKAUNA, WI 54130-2430
(920) 205-5727
(920) 759-1937

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4780-026
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40901500
WI
01
4780-026
STATE LICENSES
WI
Enumeration date
01/29/2007
Last updated
01/12/2010
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