Individual
JEAN MARIE DEPREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
200 N PATRICK BLVD STE 250, BROOKFIELD, WI 53045-5883
(414) 865-0398
Mailing address
200 N PATRICK BLVD STE 250, BROOKFIELD, WI 53045-5883
(414) 865-0398
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225X00000X
Occupational Therapist
Primary
7062-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000023532
BMC
MA
01
—
042611055
TAX ID
MA
01
—
1004745
NHP
MA
01
—
1303287
MBHP
MA
05
—
1303287
—
MA
01
—
99618201
NETWORK HEALTH
MA
01
—
M18633
BCBS
MA
Enumeration date
10/02/2012
Last updated
02/21/2023
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