Individual
KENDALL ERIN SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CLT
Contact information
Practice address
1111 NORTH RD, MAUSTON, WI 53948-9301
(608) 847-4438
Mailing address
1025 BRANDING IRON RD, WEST SALEM, WI 54669-1916
(920) 655-3686
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6455-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
418517
NATIONAL BOARD CERTIFICATION OF OCCUPATIONAL THERAPY
—
01
—
6455-26
WI DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
09/22/2021
Last updated
09/22/2021
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