Provider Demographics
NPI:1437324290
Name:HANSEN, KATHRYN SUE (OTR)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:SUE
Last Name:HANSEN
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 1:3032 96TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53126-9541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 COMMERCE DR
Practice Address - Street 2:SUITE 114
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-3700
Practice Address - Country:US
Practice Address - Phone:262-886-3431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2755-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist