Provider Demographics
NPI:1982858577
Name:WADZINSKI, DAWN MARIE (OTR)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:WADZINSKI
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:W9864 KENT RD
Mailing Address - Street 2:
Mailing Address - City:POYNETTE
Mailing Address - State:WI
Mailing Address - Zip Code:53955-9409
Mailing Address - Country:US
Mailing Address - Phone:608-635-2132
Mailing Address - Fax:
Practice Address - Street 1:W9864 KENT RD
Practice Address - Street 2:
Practice Address - City:POYNETTE
Practice Address - State:WI
Practice Address - Zip Code:53955-9409
Practice Address - Country:US
Practice Address - Phone:608-635-2132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-09
Last Update Date:2008-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1663-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist