Kim Lee Hackett, COTA
Occupational Therapy Assistant in Marshall, WI. Individual provider (NPI-1).
NPI number1699178996
StatusActive
Last updated in NPPESSep 30, 2014
Details
- NPI
- 1699178996
- Entity type
- Individual (NPI-1)
- Name
- Kim Lee Hackett
- Credential
- COTA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 30, 2014
- Last updated
- Sep 30, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 5119-27 | WI | Yes |
Practice location
425 Farnham StApt. 6
Marshall, WI 53559-9624
Phone 608-320-9203
Mailing address
425 Farnham StApt. 6
Marshall, WI 53559
Phone 608-320-9203
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