Individual
DENISE BROCKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1402 MAIN ST, BLOOMER, WI 54724-1637
(715) 568-4669
Mailing address
17071 51ST AVE N, CHIPPEWA FALLS, WI 54729-7120
(715) 726-0576
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3934-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40852300
—
WI
Enumeration date
04/17/2007
Last updated
07/08/2007
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