Provider Demographics
NPI:1013220375
Name:EICHER, DOREEN KAY (OT)
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:KAY
Last Name:EICHER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SOUTH HOLMEN DRIVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636
Mailing Address - Country:US
Mailing Address - Phone:608-347-0574
Mailing Address - Fax:920-386-9271
Practice Address - Street 1:199 HOME RD.
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:WI
Practice Address - Zip Code:53039
Practice Address - Country:US
Practice Address - Phone:920-386-3548
Practice Address - Fax:920-386-9721
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3319-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist