Individual
MRS. WENDY LYNN HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
933 NEWBURY ST, RIPON, WI 54907
(920) 748-9138
(920) 748-0527
Mailing address
933 NEWBURY ST, RIPON, WI 54907
(920) 748-9138
(920) 748-0527
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
700-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40733800
—
WI
Enumeration date
01/21/2010
Last updated
01/21/2010
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