Provider Demographics
NPI:1992559033
Name:WISER, RACHEL LOUISE (CTRS)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LOUISE
Last Name:WISER
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LOUISE
Other - Last Name:WISNIEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CTRS
Mailing Address - Street 1:6443 TUSCOBIA TRL
Mailing Address - Street 2:
Mailing Address - City:MCFARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558-9016
Mailing Address - Country:US
Mailing Address - Phone:920-450-4651
Mailing Address - Fax:
Practice Address - Street 1:2500 OVERLOOK TER
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2254
Practice Address - Country:US
Practice Address - Phone:608-256-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist