Individual
MRS. CHRISTINE MARY MATTHIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
N8015 LAKE BREEZE DR, SHERWOOD, WI 54169-9613
(920) 989-5074
(920) 759-1937
Mailing address
N8015 LAKE BREEZE DR, SHERWOOD, WI 54169-9613
(920) 989-5074
(920) 759-1937
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
108-027
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086293
NBCOT
WI
01
—
108-027
STATE LICENSURE
WI
05
—
40900700
—
WI
Enumeration date
02/14/2007
Last updated
07/09/2007
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