Individual
JACQUELINE MARIE POLECASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5219 88TH AVE, KENOSHA, WI 53144-7468
(262) 653-0850
Mailing address
5219 88TH AVE, KENOSHA, WI 53144-7468
(262) 653-0850
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6244-26
WI
Other
Enumeration date
06/04/2018
Last updated
10/18/2018
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