MARY J CROCKETT

SUPERIOR, WI
NPI1417160169
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: WI  4163026)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: MN  101276)
Enumeration Date2007-05-08
Last Update Date2007-07-08
Business Address
Ms. MARY J CROCKETT OTRL
1800 NEW YORK AVE
SUPERIOR, WI 54880
Phone number: 715-394-5591
Mailing Address
Ms. MARY J CROCKETT OTRL
21 GREEN LANE
SILVER BAY, MN 55614-1235
Phone number: 218-226-0194