Provider Demographics
NPI:1003285974
Name:SHUBERT, RHONDA L (OTR)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:L
Last Name:SHUBERT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7517 WEST COLD SPRING ROAD
Mailing Address - Street 2:GREENFIELD REHABILITATION AGENCY
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-2814
Mailing Address - Country:US
Mailing Address - Phone:414-327-6603
Mailing Address - Fax:414-327-5411
Practice Address - Street 1:7517 WEST COLD SPRING ROAD
Practice Address - Street 2:GREENFIELD REHABILITATION AGENCY
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-2814
Practice Address - Country:US
Practice Address - Phone:414-327-6603
Practice Address - Fax:414-327-5411
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5201007299225X00000X
WI4585-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist