Dricken, Marea A

Dricken, Marea A is an individual health care provider with primary practice located at 421 Camelot Dr , Fond Du Lac WI 54935. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Dricken, Marea A can be contacted via phone (920) 923-7940.

Contact Information

Primary practice address
421 Camelot Dr Fond Du Lac WI 54935
Phone: (920) 923-7940
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5798-024 Wisconsin
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 678-026 Wisconsin

Profile Details

NPI number 1205879962
LBN Legal business name Dricken, Marea A
Credentials PT, OTR
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Aug 10th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205879962 NPPES
Wisconsin MEDICAID 40341200

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