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Individual

MRS. SARA BETH GRESBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
7878 N 76TH ST, MILWAUKEE, WI 53223-3914
(414) 352-3100
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
405426
WI
225X00000X
Occupational Therapist
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41036000
WI
Enumeration date
04/19/2006
Last updated
07/11/2007
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