Individual
REANNA JEAN MOMBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
2307 HILLSHIRE DR APT 3C, SHEBOYGAN, WI 53081-5475
(262) 707-2969
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5396-27
WI
Other
Enumeration date
11/01/2017
Last updated
11/01/2017
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