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General NPI Number Information
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NPI Number | 1235826843
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Entity Type | Individual
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Provider Name | GINA MARIA ZADER OTR
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Gender | Female
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 8800 W DOYNE AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226-1222
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Country | US
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Telephone | 414-805-5879
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Fax |
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Provider Business Mailing Address
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Address Line | N9587 HORSESHOE LN
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City | MUKWONAGO
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State | WI
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Zip | 53149-1848
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Country | US
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Telephone | 414-588-8174
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Fax |
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 1566-26
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License Number State | WI
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