Provider Demographics
NPI:1578720553
Name:RICE, KATHRYN (OT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S543 HWY 27
Mailing Address - Street 2:
Mailing Address - City:WESTBY
Mailing Address - State:WI
Mailing Address - Zip Code:54667
Mailing Address - Country:US
Mailing Address - Phone:608-634-6142
Mailing Address - Fax:
Practice Address - Street 1:614 S ROCK AVE
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-1936
Practice Address - Country:US
Practice Address - Phone:608-637-2171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI64-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist