Individual
TINA M VISCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2730 W RAMSEY AVE, MILWAUKEE, WI 53221-4814
(414) 282-2600
(414) 282-2051
Mailing address
1570 N PROSPECT AVE, APT 1210, MILWAUKEE, WI 53202-2361
(414) 282-2600
(414) 282-2051
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3301-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40865400
—
WI
Enumeration date
05/08/2007
Last updated
07/08/2007
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