Individual
MRS. KELLIE JO LINDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
N27W23960 PAUL RD STE 4, PEWAUKEE, WI 53072-6327
(414) 254-1565
(262) 378-4394
Mailing address
N27W23960 PAUL RD STE 4, PEWAUKEE, WI 53072-6327
(414) 254-1565
(262) 378-4394
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1847-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760660377
NPI GROUP
WI
05
—
40898800
—
WI
Enumeration date
09/05/2006
Last updated
08/19/2024
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