Theresa Anderson, OTR

Individual provider Active NPI Occupational Therapist · Kenosha, WI

NPI 1275870784 · NPPES record last updated Jan 4, 2013

Key facts

NPI
1275870784
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5234-26 (WI)
Practice address
8633 32ND Ave
Kenosha, WI 53142-5187
Phone
(262) 694-8800
Fax
(262) 694-9125
NPI assigned
Jan 4, 2013
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)
Yes

State licenses

LicenseStateTypeSpecialty
5234-26WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5234-26 WI Yes

Addresses

Primary practice location

8633 32ND Ave
Kenosha, WI 53142-5187

Mailing address

8633 32ND Ave
Kenosha, WI 53142-5187
Phone (262) 694-8800

Other providers in Kenosha, WI

All providers in Kenosha, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.