Healthcare Provider Details

I. General information

NPI: 1336683507
Provider Name (Legal Business Name): KRISTIN HANSEN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN SEEFELDT

II. Dates (important events)

Enumeration Date: 12/07/2016
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 KAPHAEM RD
TOMAHAWK WI
54487-7800
US

IV. Provider business mailing address

304 KAPHAEM RD
TOMAHAWK WI
54487-7800
US

V. Phone/Fax

Practice location:
  • Phone: 715-453-2141
  • Fax:
Mailing address:
  • Phone: 715-453-2141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201008749
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: