Provider Demographics
NPI:1467043901
Name:JASINSKI, ANNEMARIE BARBARA
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:BARBARA
Last Name:JASINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S KLEIN DR
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-1599
Mailing Address - Country:US
Mailing Address - Phone:608-849-5016
Mailing Address - Fax:608-850-6878
Practice Address - Street 1:801 S KLEIN DR
Practice Address - Street 2:
Practice Address - City:WAUNAKEE
Practice Address - State:WI
Practice Address - Zip Code:53597-1599
Practice Address - Country:US
Practice Address - Phone:608-849-5016
Practice Address - Fax:608-850-6878
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2115-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty