Individual
MRS. TERESA L. GILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2705 ENLOE ST, HUDSON, WI 54016-8173
(715) 386-2128
(715) 386-6119
Mailing address
1608 PACIFIC AVE, EAGAN, MN 55122-1236
(651) 686-7152
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
812
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15665
HEALTH PARTNERS
—
05
—
40668500
—
WI
01
—
6407099
MEDICA
—
01
—
641671046996
PREFERRED ONE
—
01
—
7535024
AETNA
—
01
—
97G30GI
MN BCBS
MN
Enumeration date
09/26/2006
Last updated
07/09/2007
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