Provider Demographics
NPI:1740089036
Name:WOHLETZ, MALEAH
Entity type:Individual
Prefix:
First Name:MALEAH
Middle Name:
Last Name:WOHLETZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 VILLAGE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-8324
Mailing Address - Country:US
Mailing Address - Phone:262-367-2975
Mailing Address - Fax:262-367-3134
Practice Address - Street 1:2975 VILLAGE SQUARE DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8324
Practice Address - Country:US
Practice Address - Phone:414-259-2097
Practice Address - Fax:262-367-3134
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8847-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist