Individual
ANDREA LABELLE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-2600
Mailing address
2457 N 81ST ST, WAUWATOSA, WI 53213-1012
(414) 443-0944
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3094-026
WI
225XG0600X
Gerontology Occupational Therapist
3094-026
WI
225XL0004X
Low Vision Occupational Therapist
3094-026
WI
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
3094-026
WI
225XP0019X
Physical Rehabilitation Occupational Therapist
3094-026
WI
225XR0403X
Driving and Community Mobility Occupational Therapist
3094-026
WI
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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