Individual
KELSEY LYNN PUSTINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1414 JEFFERSON ST, BARABOO, WI 53913
(608) 356-1400
Mailing address
600 HIGHLAND AVENUE, MADISON, WI 53792
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056012203
IL
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922067636
—
WI
Enumeration date
11/29/2017
Last updated
07/23/2018
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