Provider Demographics
NPI:1275745820
Name:MAES, CHERYL A (OTR)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:MAES
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 1:6337 W LAKEFIELD DR
Mailing Address - Street 2:APT 6
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53219-4154
Mailing Address - Country:US
Mailing Address - Phone:414-321-1524
Mailing Address - Fax:414-671-6006
Practice Address - Street 1:6337 W LAKEFIELD DR
Practice Address - Street 2:APT 6
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53219-4154
Practice Address - Country:US
Practice Address - Phone:414-321-1524
Practice Address - Fax:414-671-6006
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1705-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist