Individual
KIMBERLY MARIE QUAYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
742 STERBENZ DR, HUDSON, WI 54016-8327
(715) 386-2128
(715) 386-6119
Mailing address
742 STERBENZ DR, HUDSON, WI 54016-8327
(715) 386-2128
(715) 386-6119
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
101136
MN
225X00000X
Occupational Therapist
Primary
1717
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1717
WISCONSIN LICENSE
WI
Enumeration date
06/17/2014
Last updated
06/17/2014
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