Individual
PAULINE J. BERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
501 W WISCONSIN ST, SPARTA, WI 54656-2332
(608) 269-0555
Mailing address
119 17TH AVE S, ONALASKA, WI 54650-3115
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4281-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40886900
—
WI
Enumeration date
04/20/2007
Last updated
04/16/2009
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