Individual
KRISTIN WITTMAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
684
SD
225XP0200X
Pediatric Occupational Therapist
0684
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5837963
—
SD
Enumeration date
04/16/2009
Last updated
05/13/2019
Update your record
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