Individual
CAROLYN HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
677 E STATE ST, BURLINGTON, WI 53105-1639
(262) 763-9531
Mailing address
5227 W WAHNER AVE, BROWN DEER, WI 53223-3041
(414) 460-0837
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5662
WI
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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