Individual
THERESA SUE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1800 SHERMAN AVE, STEVENS POINT, WI 54481-7215
(715) 344-8000
Mailing address
1785 GREENFIELD DR, STEVENS POINT, WI 54481-8947
(715) 344-1727
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
505-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811015142
—
WI
Enumeration date
03/26/2007
Last updated
10/15/2012
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