Individual
MRS. KIMBERLY NICOLE WITTMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1130 COLLINS RD, JEFFERSON, WI 53549-2939
(920) 674-3170
Mailing address
1130 COLLINS RD, JEFFERSON, WI 53549-2939
(920) 674-3170
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
997-27
WI
Other
Enumeration date
12/12/2012
Last updated
12/09/2015
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