Provider Demographics
NPI:1083235717
Name:HUENERS, PAULA JO (OTR)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:JO
Last Name:HUENERS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W7136 HERAM RD
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-9494
Mailing Address - Country:US
Mailing Address - Phone:608-526-9784
Mailing Address - Fax:
Practice Address - Street 1:W7136 HERAM RD
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636-9494
Practice Address - Country:US
Practice Address - Phone:608-526-9784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1818-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist