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Individual

TERI OGIBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
3401 CRANBERRY BLVD, WESTON, WI 54476-5217
(715) 393-2097
(715) 393-2105
Mailing address
1522 SOUTH RD, MOSINEE, WI 54455-9614

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3381-026
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3381-026
STATE LICENSURE
WI
05
40877400
WI
Enumeration date
03/07/2006
Last updated
11/17/2022
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