NPI 1417120478

County of Waushara

Organisation Early Intervention Provider Agency Wautoma, WI

Practice location

Address: 380 S Townline Rd, Wautoma, WI 54982-6900
Phone: (920) 787-6550
Fax: (920) 787-0421

Authorised official

Name: Jen Gonzales
Title: Account Clerk
Phone: (920) 787-6550

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X Licence 1980 (WI)

Other Early Intervention Provider Agency providers in Wisconsin →

Registry record

NPI: 1417120478
Entity type: Organization
NPI issued: 10 Apr 2008
Record last updated: 7 Nov 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.