Teresa Westberg, COTA

Individual provider Active NPI Occupational Therapy Assistant · Algoma, WI

NPI 1386744217 · NPPES record last updated Aug 9, 2024

Key facts

NPI
1386744217
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
85 (WI)
Practice address
1510 Fremont St
Algoma, WI 54201-1948
Phone
(920) 487-9888
Fax
(920) 433-8765
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
85WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Door County Memorial Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 85 WI Yes

Addresses

Primary practice location

1510 Fremont St
Algoma, WI 54201-1948

Mailing address

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 487-9888

Other identifiers

IdentifierTypeStateIssuer
40645400MedicaidWI

Other providers in Algoma, WI

All providers in Algoma, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.