Berra, Pauline J.
Berra, Pauline J. is an individual health care provider with primary practice located at 501 W Wisconsin St , Sparta WI 54656-2332. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Berra, Pauline J. can be contacted via phone (608) 269-0555.Contact Information
Primary practice address
501 W Wisconsin St
Sparta WI 54656-2332
Phone: (608) 269-0555
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 4281-026 | Wisconsin |
Profile Details
| NPI number | 1629295449 |
|---|---|
| LBN Legal business name | Berra, Pauline J. |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2007 |
| Last updated | Apr 16th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629295449 | NPPES |
| Wisconsin | MEDICAID | 40886900 |
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