Individual
CAREY ANN KOLACZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
19525 W NORTH AVE, BROOKFIELD, WI 53045-4107
(262) 780-3810
Mailing address
19525 W NORTH AVE, BROOKFIELD, WI 53045-4107
(262) 780-3810
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4956-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4956-26
OCCUPATIONAL THERAPIST
WI
Enumeration date
09/19/2012
Last updated
09/19/2012
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