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General NPI Number Information
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NPI Number | 1881806487
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Entity Type | Individual
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Provider Name | MRS. MIRANDA ZEEVELD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 300 MILL ST EMPLOYEE HEALTH CENTER
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City | SHEBOYGAN FALLS
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State | WI
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Zip | 53085-1807
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Country | US
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Telephone | 920-467-5212
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 TRI PARK WAY SUITE A
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City | APPLETON
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State | WI
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Zip | 54914-1601
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Country | US
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Telephone | 920-830-6697
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1954-027
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License Number State | WI
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