Individual
MARY HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 WISCONSIN AVE, RACINE, WI 53403-1978
(262) 687-2640
Mailing address
831 E MORGAN AVE, MILWAUKEE, WI 53207-3427
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5175-27
WI
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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