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Individual

MRS. SUE ANN WIMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3878 BEVERLY AVE NE, BLDG H SUITE 11, SALEM, OR 97305-1394
(503) 576-4528
Mailing address
3878 BEVERLY AVE NE, BLDG H SUITE 11, SALEM, OR 97305-1394
(503) 576-4528

Taxonomy

Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
418863
OR
225XP0200X
Pediatric Occupational Therapist
418863
OR

Other

Enumeration date
12/08/2011
Last updated
01/17/2014
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