Individual
ALANE M BOUTELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1100 E VERONA AVE, VERONA, WI 53593-8717
(608) 845-6601
(608) 845-1264
Mailing address
2448 S 102ND ST, SUITE # 340, MILWAUKEE, WI 53227-2466
(414) 329-2500
(414) 329-2501
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4767-027
WI
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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