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General NPI Number Information
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NPI Number | 1033234430
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Entity Type | Individual
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Provider Name | LINDA MARIE WETZEL OTR
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 500 RIVERVIEW AVE
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City | WAUKESHA
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State | WI
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Zip | 53188-3632
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Country | US
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Telephone | 262-424-0094
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Fax | 262-896-6879
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Provider Business Mailing Address
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Address Line | 439 S MORELAND BLVD
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City | WAUKESHA
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State | WI
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Zip | 53188-4915
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Country | US
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Telephone | 262-547-6832
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Fax | 262-896-6879
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 40796900
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License Number State | WI
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