Individual
MISS HOLLY MARIE PETE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
1616 W BENDER RD, GLENDALE, WI 53209-3802
(414) 228-8700
Mailing address
3805 PORTAGE RD APT 1, MADISON, WI 53704-2765
(608) 931-4278
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4638-027
WI
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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