Jenelle Peloquin
Individual provider Active NPI Occupational Therapy Assistant · Baldwin, WI
NPI 1306203351 · NPPES record last updated Jan 21, 2016
Key facts
- NPI
- 1306203351
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 5244-27 (WI)
- Practice address
- 650 Birch St
Baldwin, WI 54002-9348 - Phone
- (715) 688-2506
- NPI assigned
- Jan 21, 2016
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 202092 | MN | MD | Occupational Therapy Assistant |
| 5244-27 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5244-27 | WI | Yes |
| Occupational Therapy Assistant | 224Z00000X | 202092 | MN |
Addresses
Primary practice location
650 Birch St
Baldwin, WI 54002-9348
Mailing address
650 Birch St
Baldwin, WI 54002-9348
Other providers in Baldwin, WI
- New Richmond Family Care, LLC
- Julie Niekamp
- Alisa Marie Onken
- Corrine Nicole Owens
- Luke Anthony Owens
- Carol June Poppy
- Raymond Leroy Price
- Purdy Family Dentistry
- Nilin Raj
- Rasmussen Village Pharmacy, Inc.
All providers in Baldwin, WI · Occupational Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2016. 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.