Danielle Bertrand, COTA
Individual provider Active NPI Occupational Therapy Assistant · Green Bay, WI
NPI 1699299909 · NPPES record last updated Jul 28, 2017
Key facts
- NPI
- 1699299909
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 5288-27 (WI)
- Practice address
- 1040 Pilgram Way
Green Bay, WI 54304 - Phone
- (920) 405-3522
- NPI assigned
- Jul 28, 2017
- 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 |
|---|---|---|---|
| 5288-27 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5288-27 | WI | Yes |
Addresses
Primary practice location
1040 Pilgram Way
Green Bay, WI 54304
Mailing address
1040 Pilgrim Way
Green Bay, WI 54304-5028
Other providers in Green Bay, WI
- Nicole Berndt
- Rehna Marie Bernhardt
- Ryan Michael Berns
- Carla Renee Berscheit
- Mark W Bertagnoli
- Mitchell Bertrand
- Ursula Bertrand
- Adam J Bertuli
- Crystal D Besaw
- Karen Besiada Hansen
All providers in Green Bay, WI · Occupational Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2017. 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.