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Individual

JACLYN E MEYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOTR

Contact information

Practice address
5219 88TH AVE, KENOSHA, WI 53144-7468
(262) 653-0850
Mailing address
5219 88TH AVE, KENOSHA, WI 53144-7468

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5949-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5949-26
OCCUPATIONAL THERAPY STATE LICENSE
WI
Enumeration date
11/22/2016
Last updated
07/02/2019
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