Individual
MS. KATHRYN M WIBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3015 S 45TH ST, MILWAUKEE, WI 53219-3415
(262) 909-5321
Mailing address
3015 S 45TH ST, MILWAUKEE, WI 53219-3415
(262) 909-5321
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5773-27
WI
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
5773-27
WI
Other
Enumeration date
06/08/2021
Last updated
04/07/2026
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