Individual
HOLLY L GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
13025 8TH ST, OSSEO, WI 54758-7634
(715) 597-7907
Mailing address
13025 8TH ST, OSSEO, WI 54758-7634
(715) 597-7907
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4347
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1076306
NBCOT CERT
—
05
—
40897300
—
WI
Enumeration date
01/05/2007
Last updated
04/28/2009
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