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Individual

MRS. LAURA JANE WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
802 E COUNTY HWY B, TERRACEVIEW LIVING CENTER, SHELL LAKE, WI 54871-0609
(715) 468-7292
(715) 468-4232
Mailing address
6931 LAKEVIEW ROAD, SIREN, WI 54872-9015
(715) 349-2025
(715) 468-4232

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1845027
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40887600
WI
Enumeration date
06/19/2007
Last updated
07/08/2007
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