Individual
CRYSTAL MARIE TADYCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1700 MIDWAY RD, MENASHA, WI 54952-1230
(920) 739-0111
Mailing address
1700 MIDWAY RD, MENASHA, WI 54952-1230
(920) 739-0111
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7119-27
WI
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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