Individual
TARYN MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
3360 GATEWAY RD, BROOKFIELD, WI 53045-5115
(262) 923-7101
Mailing address
3360 GATEWAY RD, BROOKFIELD, WI 53045-5115
(262) 923-7101
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8636
WI
Other
Enumeration date
06/24/2024
Last updated
04/30/2026
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