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Individual

MRS. ANN R FAHEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1414 S PARK ST, MADISON, WI 53715-2106
(608) 417-8250
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1633-026
WI
225XH1200X
Hand Occupational Therapist
1633-026
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40534400
WI
Enumeration date
12/08/2006
Last updated
01/02/2015
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