Basic Information
| Provider Information | |||||||||
| NPI: | 1972093292 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ATTARWALA | ||||||||
| FirstName: | MUBARAKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3330 ROBERTS ST | ||||||||
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| City: | FRANKSVILLE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531269559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2138224761 | ||||||||
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| Practice Location | |||||||||
| Address1: | 709 MEADOW PARK DR | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535259777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6086762202 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2018 | ||||||||
| LastUpdateDate: | 08/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.