Individual
MISS LAIKEN ADDIE IMMORMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
814 W 14TH ST, MARSHFIELD, WI 54449-4030
(715) 387-1188
Mailing address
N14865 EVERGREEN AVE, THORP, WI 54771-7521
(715) 512-1058
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
WI
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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