Individual
MS. MARY ELLEN WEIDNER-RUEDIGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
W5004 BEECHNUT AVENUE, REDGRANITE, WI 54970-6904
(920) 470-8442
Mailing address
W5004 BEECHNUT AVENUE, REDGRANITE, WI 54970-6904
(920) 470-8442
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1547-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40577400
—
WI
Enumeration date
12/05/2007
Last updated
12/10/2012
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