Individual
DIANN LOUISE IKELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
S94W31656 GENA DR, MUKWONAGO, WI 53149-8273
(414) 588-9466
(262) 378-5101
Mailing address
S94W31656 GENA DR, MUKWONAGO, WI 53149-8273
(414) 588-9466
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1970-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1970-026
OCCUPATIONAL THERAPIST LICENSE
WI
05
—
40783900
—
WI
Enumeration date
04/22/2008
Last updated
10/19/2012
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