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Individual

CARRIE HOSTETTLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
N4610 PINE ST, NEW LONDON, WI 54961-8039
(920) 982-3713
Mailing address
N4610 PINE ST, NEW LONDON, WI 54961-8039
(920) 982-3713

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1615-27
WI

Other

Enumeration date
08/21/2008
Last updated
03/12/2009
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