Provider Demographics
NPI:1396177887
Name:KEEFER, ANNE MARIE (OTR)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:KEEFER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:POLCHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:5000 W NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53295-1000
Mailing Address - Country:US
Mailing Address - Phone:414-384-2000
Mailing Address - Fax:414-382-5395
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-1000
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:414-382-5395
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI205-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist