Individual
JENNA SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-2600
(262) 434-2601
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5523-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100305740
—
WI
Enumeration date
08/04/2016
Last updated
03/05/2025
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