Individual
MRS. JENNIFER LYNN LABONTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1119 N WISCONSIN ST, PORT WASHINGTON, WI 53074-1209
(262) 284-5892
Mailing address
1110 SPRUCE ST, WEST BEND, WI 53090-5451
(262) 306-8042
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3834-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40849600
—
WI
Enumeration date
05/02/2007
Last updated
07/08/2007
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