Individual
KELLY EILEEN HETTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
700 N MAIN ST, VERONA, WI 53593-1103
(608) 845-4313
Mailing address
700 N MAIN ST, VERONA, WI 53593-1103
(608) 845-4313
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1669-27
WI
Other
Enumeration date
03/31/2026
Last updated
03/31/2026
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