Individual
KAYLEE MARIE MITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
725 S WEBSTER AVE, GREEN BAY, WI 54301-3500
(920) 433-3655
(920) 433-3539
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6783
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
436589
NATIONAL BOARD CERTIFICATION IN OCCUPATIONAL THERAPY
—
Enumeration date
09/10/2021
Last updated
09/13/2021
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