Individual
MRS. SHARON ANN VANSTIPHOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3375 W BREWSTER ST, APPLETON, WI 54914-1602
(920) 749-5870
Mailing address
3375 W BREWSTER ST, APPLETON, WI 54914-1602
(920) 749-5870
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
591-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40800000
—
WI
Enumeration date
11/20/2007
Last updated
11/20/2007
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