Provider Demographics
NPI:1033202528
Name:MAXWELL-JONES, MARIE ANN (OTR)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:ANN
Last Name:MAXWELL-JONES
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 1:278 MULBERRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1076
Mailing Address - Country:US
Mailing Address - Phone:262-646-2129
Mailing Address - Fax:
Practice Address - Street 1:N3995 ANNEX ROAD
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:WI
Practice Address - Zip Code:53549
Practice Address - Country:US
Practice Address - Phone:920-674-8718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI414-026225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics