Individual
BRENDA PRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1350 RIVER RUN DR, WISCONSIN RAPIDS, WI 54494-5487
(715) 421-7130
Mailing address
3550 110TH ST S, WISCONSIN RAPIDS, WI 54494-8604
(715) 213-9623
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1474-027
WI
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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