MISS Elizabeth Widicus, OT

NPI #1154762912 in Oconomowoc, Wisconsin

Provider Information

NPI Number: 1154762912
Entity Type: Individual
Name: MISS Elizabeth Widicus, OT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: OT
Enumeration Date: Jul 9, 2013
Last Updated: Jul 9, 2013

Practice Location

Address: 2195 N SUMMIT VILLAGE WAY
City: Oconomowoc
State: Wisconsin
ZIP Code: 53066-8675
Phone: (262) 560-2426

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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