Individual
JOLEEN TICHELAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
17280 W NORTH AVE, BROOKFIELD, WI 53045-4366
(262) 780-0707
Mailing address
16525 NANCY LN, BROOKFIELD, WI 53005-5165
(618) 558-1523
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5109
WI
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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