Sjaardema, Andrea

Sjaardema, Andrea is an individual health care provider with primary practice located at 4103 60Th St , Kenosha WI 53144-2509. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as her primary health care specialty. Sjaardema, Andrea can be contacted via phone (262) 652-1111.

Contact Information

Primary practice address
4103 60Th St Kenosha WI 53144-2509
Phone: (262) 652-1111
Fax: (262) 652-1124
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X 1891-027 Wisconsin

Profile Details

NPI number 1104965474
LBN Legal business name Sjaardema, Andrea
Credentials Certified Occupational Therapy Assistant (COTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104965474 NPPES
Wisconsin MEDICAID 41040400

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