Individual
MRS. DANIELLE ELAINE KINGDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3939 S 92ND ST, GREENFIELD, WI 53227-3448
(414) 546-7346
(414) 546-1825
Mailing address
1227 ELM LAWN, WAUWATOSA, WI 53213
(414) 476-3353
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3755026
WI
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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