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Individual

MARY T. ANNEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
1040 PILGRIM WAY, WOODSIDE LUTHERAN HOME, ASHWAUBENON, WI 54304
(920) 405-3522
(920) 405-3523
Mailing address
1040 PILGRIM WAY, ASHWAUBENON, WI 54304
(920) 405-3522

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
713-026
WI

Other

Enumeration date
06/09/2010
Last updated
06/11/2010
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