Individual
MRS. MICHELLE VANDEWETTERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1142 ORLANDO DR, DE PERE, WI 54115-9484
(920) 339-0700
Mailing address
W5947 SWEET PEA DR, APPLETON, WI 54915-5218
(920) 450-4820
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
268126
WI
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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