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Individual

AMY L WISENBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L

Contact information

Practice address
6209 W SAGINAW HWY STE A&B, LANSING, MI 48917-2491
(800) 974-4378
(630) 515-1536
Mailing address
24014 W RENWICK RD UNIT 206, PLAINFIELD, IL 60544-8711
(800) 974-4378
(630) 515-1536

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201013867
MI

Other

Enumeration date
04/12/2024
Last updated
12/04/2025
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