Individual
MRS. ROBYN LOUISE VANDE BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3415 SHERIDAN RD, KENOSHA, WI 53140-1924
(262) 657-6175
Mailing address
6775 BOBOLINK RD, RACINE, WI 53402-1397
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
564027
WI
Other
Enumeration date
08/21/2007
Last updated
04/18/2008
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