Provider Demographics
NPI:1184659302
Name:SNEBOLD, DOROTHY (OTR/LMT)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:
Last Name:SNEBOLD
Suffix:
Gender:F
Credentials:OTR/LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 BIRKA LN
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-2087
Mailing Address - Country:US
Mailing Address - Phone:608-769-9845
Mailing Address - Fax:
Practice Address - Street 1:1553 BIRKA LN
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-2087
Practice Address - Country:US
Practice Address - Phone:608-769-9845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI820-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist