Individual
DAEDRE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 BROADWAY ST, BARABOO, WI 53913-2183
(608) 355-4200
Mailing address
505 BROADWAY ST, BARABOO, WI 53913-2183
(608) 355-4200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3125-26
WI
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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