Tiffany Berth
Occupational Therapist in Oconto, WI. Individual provider (NPI-1).
NPI number1679679641
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1679679641
- Entity type
- Individual (NPI-1)
- Name
- Tiffany Berth
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | 2754-26 | – | Yes |
Practice location
501 Park AveOconto, WI 54153-1612
Phone 920-834-6875
Mailing address
N2059 Bonnie LnMarinette, WI 54143-9469
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