Individual
WENDY L FASSBENDER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
2323 N CASALOMA DR, APPLETON, WI 54913-8284
(920) 730-8833
Mailing address
PO BOX 7700, APPLETON, WI 54912-7079
(920) 730-8833
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1216027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40792300
—
WI
Enumeration date
05/18/2006
Last updated
07/08/2007
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