Individual
MRS. LAUREN KELLY GILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
244 N MACY ST, FOND DU LAC, WI 54935-3362
(920) 322-8546
Mailing address
244 N MACY ST, FOND DU LAC, WI 54935-3326
(920) 322-8546
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5740-26
WI
Other
Enumeration date
06/08/2016
Last updated
06/23/2020
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