Individual
MRS. JOLENE MARIE HERLITZKE-FOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
E7404A COUNTY ROAD BB, VIROQUA, WI 54665-7502
(608) 637-5422
Mailing address
N5116 GREEN COULEE RD, ONALASKA, WI 54650-8208
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2063-27
WI
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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