Individual
LISA ANN WACHOWIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3129 MICHIGAN AVE, SHEBOYGAN, WI 53081-3062
(920) 458-1155
Mailing address
3129 MICHIGAN AVE, SHEBOYGAN, WI 53081-3062
(920) 458-1155
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
387-027
WI
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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