Provider Demographics
NPI:1164680443
Name:VOGELSBERG, TRICIA LYNN (OTRL)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:LYNN
Last Name:VOGELSBERG
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MRS
Other - First Name:TRICIA
Other - Middle Name:LYNN
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:8800 HWY 61
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:WI
Mailing Address - Zip Code:53813
Mailing Address - Country:US
Mailing Address - Phone:608-723-2113
Mailing Address - Fax:608-723-2210
Practice Address - Street 1:8800 HWY 61
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813
Practice Address - Country:US
Practice Address - Phone:608-723-2113
Practice Address - Fax:608-723-2210
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3388026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist