Individual
MICHELLE MIKLESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
19395 W CAPITOL DR STE 200, BROOKFIELD, WI 53045-2736
(262) 923-7101
(262) 923-7178
Mailing address
19395 W CAPITOL DR STE 200, BROOKFIELD, WI 53045-2736
(262) 923-7101
(262) 923-7178
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1208
WI
Other
Enumeration date
12/01/2017
Last updated
12/01/2017
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