Mylinda Rose Barisas-Matula, OT

Individual provider Active NPI Occupational Therapist · Sheboygan, WI

NPI 1104049402 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104049402
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
1913-026 (WI)
Practice address
2629 N 7TH St
Sheboygan, WI 53083-4932
Phone
(920) 451-5634
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1913-026WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1913-026 WI Yes

Addresses

Primary practice location

2629 N 7TH St
Sheboygan, WI 53083-4932

Mailing address

417 Saint Clair Ave
Sheboygan, WI 53081-3562
Phone (920) 451-4651

Other providers in Sheboygan, WI

All providers in Sheboygan, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.