Individual
JESSICA AMBER VAN HANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
325 E FLORIDA AVE, APPLETON, WI 54911
(920) 738-4870
(920) 759-1937
Mailing address
325 E. FLORIDA AVE, APPLETON, WI 54911
(920) 738-4870
(920) 759-1937
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4357-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1075010
NBCOTA
—
05
—
40900600
—
WI
01
—
4357-026
STATE OF WI
WI
Enumeration date
03/05/2007
Last updated
05/19/2015
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