Mary L Hertel, OT

Individual provider Active NPI Occupational Therapist · Woodruff, WI

NPI 1467535948 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1467535948
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
1790-026 (WI)
Practice address
240 Maple Street
Woodruff, WI 54568-0470
Phone
(715) 356-8000
NPI assigned
Oct 20, 2006
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

LicenseStateTypeSpecialty
1790-026WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1790-026 WI Yes

Addresses

Primary practice location

240 Maple Street
Woodruff, WI 54568-0470

Mailing address

240 Maple Street
PO Box 470
Woodruff, WI 54568-0470
Phone (715) 356-8000

Other identifiers

IdentifierTypeStateIssuer
40804500MedicaidWI

Other providers in Woodruff, WI

All providers in Woodruff, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.