Individual
OLIVIA RENEE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1101 E SOUTH RIVER ST, APPLETON, WI 54915-2223
(920) 830-9911
Mailing address
228 CRESTVIEW CIR, WRIGHTSTOWN, WI 54180-1078
(920) 450-4034
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8169-26
WI
Other
Enumeration date
04/04/2023
Last updated
07/17/2025
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