Provider Demographics
NPI:1073533378
Name:HERING, ANN M (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:HERING
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:DIEDRICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:N6270 BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:WI
Mailing Address - Zip Code:53073-3423
Mailing Address - Country:US
Mailing Address - Phone:920-893-6072
Mailing Address - Fax:
Practice Address - Street 1:1125 N 13TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3281
Practice Address - Country:US
Practice Address - Phone:920-208-9648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2100-026225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics