Provider Demographics
NPI:1770322406
Name:MROSKO, KARINA JEWELL (OTR/L)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:JEWELL
Last Name:MROSKO
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:N24W22341 ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1157
Mailing Address - Country:US
Mailing Address - Phone:262-744-2083
Mailing Address - Fax:
Practice Address - Street 1:995 S SAWYER RD
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-9243
Practice Address - Country:US
Practice Address - Phone:262-201-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist