Individual
HANNAH BANECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
901 MULBERRY ST, LAKE MILLS, WI 53551-1335
(920) 648-8344
Mailing address
224 CLARK ST, WATERTOWN, WI 53094-6918
(920) 285-6806
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8995-26
WI
Other
Enumeration date
09/01/2025
Last updated
09/01/2025
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