Gretchen Catherine Hafemeister COTA

NPI 1396967410 - Occupational Therapy Assistant - 224Z00000X

NPI Details
NPI 1396967410
Gender Female
Enumeration Date 05/02/2007
Last Updated 02/01/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
845 SOUTH MAIN STREET
SUITE 120
FOND DU LAC WI, 54935, US
Phone (920) 322-0447
Fax (920) 322-1362
Business Location
845 SOUTH MAIN STREET
SUITE 120
FOND DU LAC WI, 54935, US
Phone (920) 322-0447
Fax (920) 322-1362
Toxanomy
Taxonomy Code 224Z00000X
License State Wisconsin
License Number 1173-027
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According to our database, Gretchen Catherine Hafemeister COTA NPI is 1396967410, taxonomy code is 224Z00000X and license number is 1173-027, license state is located at Wisconsin. Gretchen Catherine Hafemeister COTA physically located at 845 South Main Street, Fond Du Lac WI, 54935. NPI Number Gretchen Catherine Hafemeister COTA has the Individual type.

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1396967410 NPI number is provided on an as is basis without warranty of any kind. 1396967410 is maintained by the National Plan & Provider Enumeration System. The contents of Gretchen Catherine Hafemeister COTA are for informational purposes only.