Individual
MRS. JESSICA H HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3216 W HIGHLAND BLVD, (414) 344-6515, MILWAUKEE, WI 53208-3252
(414) 344-6515
Mailing address
170 W RAINBOW RIDGE DR, 411, OAK CREEK, WI 53154-2961
(414) 202-5251
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5854-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740689710
—
WI
Enumeration date
01/24/2017
Last updated
01/24/2017
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