Tiffany Berth

Individual provider Active NPI Occupational Therapist · Oconto, WI

NPI 1679679641 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1679679641
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2754-26
Practice address
501 Park Ave
Oconto, WI 54153-1612
Phone
(920) 834-6875
NPI assigned
Sep 16, 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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2754-26 Yes

Addresses

Primary practice location

501 Park Ave
Oconto, WI 54153-1612

Mailing address

N2059 Bonnie LN
Marinette, WI 54143-9469

Other providers in Oconto, WI

All providers in Oconto, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.