Provider Demographics
NPI:1144751082
Name:TENPAS, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:TENPAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3512
Mailing Address - Country:US
Mailing Address - Phone:414-805-5877
Mailing Address - Fax:414-805-6688
Practice Address - Street 1:8700 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3512
Practice Address - Country:US
Practice Address - Phone:414-805-5877
Practice Address - Fax:414-805-6688
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI559-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist