Becky Lynn Watral, OTR

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

2084-26 Issued in WI

Practice address

240 Maple Ave
Mukwonago, WI 53149-8475

Phone

(262) 928-1921

Fax

(262) 363-1918

NPI assigned

Jan 23, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Becky Lynn Nadeau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1841052198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 BUCKEY ST",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531209635",
            "telephone_number": "262-928-1921",
            "fax_number": "262-363-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MAPLE AVE",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498475",
            "telephone_number": "262-928-1921",
            "fax_number": "262-363-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATRAL",
        "first_name": "BECKY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "WI",
            "license": "2084-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BECKY",
            "last_name": "NADEAU",
            "middle_name": "LYNN",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Rehabilitation Occupational Therapist in Mukwonago, WI
• Providers in Mukwonago, WI by specialty
• Physical Rehabilitation Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.