Individual
MRS. KATIE JO BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT, CHT
Contact information
Practice address
7901 S 6TH ST, OAK CREEK, WI 53154-2010
(414) 346-8000
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4822
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100009504
—
WI
Enumeration date
04/13/2010
Last updated
06/24/2024
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