Individual
LEONNA MARIE IVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1010 E WAUSAU AVE, WAUSAU, WI 54403-3101
(715) 842-2028
Mailing address
1200 S CENTER AVE, MERRILL, WI 54452-8220
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7005-27
WI
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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