Individual
MRS. JODI LYNN NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
400 WATER AVE, HILLSBORO, WI 54634
(608) 489-8260
(608) 489-8193
Mailing address
PO BOX 371, WONEWOC, WI 53968
(608) 464-7690
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1367027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
693182
DPI
WI
Enumeration date
10/16/2006
Last updated
07/08/2007
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