Individual
MRS. JENNIFER LOUISE BARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1401 CHURCHILL ST, WAUPACA, WI 54981-2027
(715) 258-8131
(715) 258-0179
Mailing address
E1614 RURAL RD, WAUPACA, WI 54981-5921
(715) 256-8978
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
1632-027
WI
225X00000X
Occupational Therapist
Primary
5159-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40847100
—
WI
Enumeration date
05/07/2007
Last updated
04/03/2012
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