Provider Demographics
NPI:1184356792
Name:KRAMER, KELLI LAUREN (OTR/L)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:LAUREN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10512 W CORTEZ CIR APT 28
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-1549
Mailing Address - Country:US
Mailing Address - Phone:712-260-5375
Mailing Address - Fax:
Practice Address - Street 1:7711 FREELAND CT
Practice Address - Street 2:
Practice Address - City:GREENDALE
Practice Address - State:WI
Practice Address - Zip Code:53129-1658
Practice Address - Country:US
Practice Address - Phone:414-210-0088
Practice Address - Fax:414-509-1630
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist