Debra Louise Kowalkowski-Funk, OTR
Individual provider Active NPI Occupational Therapist · Abrams, WI
NPI 1497020838 · NPPES record last updated Mar 19, 2012
Key facts
- NPI
- 1497020838
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 945-26 (WI)
- Practice address
- 5935 Forest Lake LN
Abrams, WI 54101-9513 - Phone
- (920) 826-5665
- NPI assigned
- Mar 19, 2012
- 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 |
|---|---|---|---|
| 945-26 | WI | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 945-26 | WI | Yes |
Addresses
Primary practice location
5935 Forest Lake LN
Abrams, WI 54101-9513
Mailing address
5935 Forest Lake LN
Abrams, WI 54101-9513
Phone (920) 826-5665
Other providers in Abrams, WI
All providers in Abrams, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2012. 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.