Tiffany Ann Salentine, OTR/L
Individual provider Active NPI Occupational Therapist · Hobart, WI
NPI 1972200012 · NPPES record last updated Mar 24, 2023
Key facts
- NPI
- 1972200012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 8170-26 (WI)
- Practice address
- 650 Centennial Centre Blvd
Hobart, WI 54155-8989 - Phone
- (920) 006-8583
- NPI assigned
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230406000983 | WI | Practitioner - Occupational Therapist in Private Practice | 9032584925 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8170-26 | WI | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 8170-26 | WI | Yes |
Addresses
Primary practice location
650 Centennial Centre Blvd
Hobart, WI 54155-8989
Mailing address
12107 Tannery Rd
Mishicot, WI 54228-9408
Phone (920) 255-5544
Other providers in Hobart, WI
- Elizabeth Anne Eastman
- Megha Giri
- Dillon Matthew Hock
- Samantha A Knuff
- Melissa L McAllister
- Scal of Hobart, LLC
- The Extra Pass Mentoring, LLC
- Micah James Thill
- Tsav Ntuj LLC
- Sandra Renee Warner
All providers in Hobart, 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 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.