Provider Demographics
NPI:1861625345
Name:WOSEPKA, LINDSEY (OTR)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:WOSEPKA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:WI
Mailing Address - Zip Code:54002-9358
Mailing Address - Country:US
Mailing Address - Phone:715-688-2506
Mailing Address - Fax:715-688-2505
Practice Address - Street 1:640 ELM ST
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:WI
Practice Address - Zip Code:54002-9358
Practice Address - Country:US
Practice Address - Phone:715-688-2506
Practice Address - Fax:715-688-2505
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4783-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist