Carla Renee Berscheit, OT

Individual provider Active NPI Occupational Therapist · Green Bay, WI

NPI 1366427452 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1366427452
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
3507-026 (WI)
Practice address
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone
(920) 430-4560
NPI assigned
Dec 12, 2005
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)
Yes

State licenses

LicenseStateTypeSpecialty
3507WIMDGeneral Practice Dentistry
3507-026WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3507-026 WI Yes

Addresses

Primary practice location

1630 Commanche Ave
Green Bay, WI 54313-5753

Mailing address

1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4560

Other providers in Green Bay, WI

All providers in Green Bay, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.