Individual
CARLIE MARIE KLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
555 REDBIRD CIR, DE PERE, WI 54115-7977
(920) 338-6870
(920) 338-6829
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
WI
Other
Enumeration date
01/09/2024
Last updated
08/22/2024
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