Individual
AMY R BEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
768 ALDRO RD, HUDSON, WI 54016-7825
(715) 781-7189
Mailing address
768 ALDRO RD, HUDSON, WI 54016-7825
(715) 781-7189
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
202198
MN
224Z00000X
Occupational Therapy Assistant
Primary
5333-27
WI
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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