Provider Demographics
NPI:1083714927
Name:STEFFEN, LISA A (OTR)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:STEFFEN
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 1:240 KLEEMAN CT
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-3418
Mailing Address - Country:US
Mailing Address - Phone:715-526-2507
Mailing Address - Fax:
Practice Address - Street 1:2900 CURRY LN
Practice Address - Street 2:N.E.W. CURATIVE REHABILITATION, INC.
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-5857
Practice Address - Country:US
Practice Address - Phone:920-468-1161
Practice Address - Fax:920-965-2653
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2247-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40744700Medicaid