Most Relevant Information
Provider Data
| NPI Number: | 1003026121 |
| Provider Name: | KELLY JO LOESCH MT-BC, WMTR |
| Entity Type: | Individual |
| Taxonomy Code: | 225A00000X |
| Specialty: | Music Therapist |
| License Number: | 82-38 |
Most Important Dates
| Enumeration Date: | 05/23/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1125 JAMES DR
HARTLAND
WI
530298310
Practice Location Phone/Fax
| Phone: | 2623676663 |
| Fax: |
Provider Mailing Location
W156N10531 JEFFERSON LN
GERMANTOWN
WI
530224123
Provider Mailing Phone/Fax
| Phone: | 4146514432 |
| Fax: |