Individual
KAITLYN CORNELLA-CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
17280 W NORTH AVE, BROOKFIELD, WI 53045-4366
(262) 928-8830
Mailing address
1012 N BLUESPRUCE CIR, HARTLAND, WI 53029-8681
(262) 347-8002
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
7202-26
WI
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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