Tonya S Benz
Individual provider Active NPI Occupational Therapist · Verona, WI
NPI 1104848688 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104848688
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 3877-26 (WI)
- Practice address
- 6369 Goose Lake Dr
Compliance Mail Code-2433
Verona, WI 53593-9255 - Phone
- (608) 848-1632
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3877-26 | WI | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3877-26 | WI | Yes |
Addresses
Primary practice location
6369 Goose Lake Dr
Compliance Mail Code-2433
Verona, WI 53593-9255
Mailing address
6369 Goose Lake Dr
Compliance Mail Code-2433
Verona, WI 53593-9255
Phone (608) 848-1632
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3877-26 | Other | WI | OT |
Other providers in Verona, WI
- Ryan Bauer
- Brooke Bayer
- John W Beasley
- Tabitha Jade Beckwith
- Danielle Marie Bentley
- Sarah Mattison Berndt
- David Alan Besley
- Emily Bessler
- Joseph P Beyler
- Steven M Beyler
All providers in Verona, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.