Individual
MS. MARY J KRAGNESS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
AOTA
Contact information
Practice address
808 MAIN ST E, MENOMONIE, WI 54751-2735
(715) 232-1116
Mailing address
E9275 780TH AVE, COLFAX, WI 54730-5100
(715) 962-3673
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1308-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40529400
—
WI
Enumeration date
05/20/2006
Last updated
07/09/2007
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