Provider Demographics
NPI:1376035857
Name:MORREALE, TERESA
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:MORREALE
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 1:801 S BRIGGS ST FL 2
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-9591
Mailing Address - Country:US
Mailing Address - Phone:815-722-1757
Mailing Address - Fax:
Practice Address - Street 1:801 S BRIGGS ST FL 2
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60433-9591
Practice Address - Country:US
Practice Address - Phone:815-722-1757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist