Provider Demographics
NPI:1164696050
Name:STEELE, JOAN M (OT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:STEELE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 W DEAN RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2637
Mailing Address - Country:US
Mailing Address - Phone:414-371-7397
Mailing Address - Fax:
Practice Address - Street 1:7300 W DEAN RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-2637
Practice Address - Country:US
Practice Address - Phone:414-371-7397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI783-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40644900Medicaid
WI783-026OtherOCCUPATIONAL THERAPIST LICENSE
WI974881OtherNATIONAL CERTIFICATION NUMBER