Provider Demographics
NPI:1427008408
Name:MCGRATH, MAUREEN F (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:F
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:F
Other - Last Name:MCGRATH-DORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2323 N CASALOMA DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8284
Mailing Address - Country:US
Mailing Address - Phone:920-730-8833
Mailing Address - Fax:
Practice Address - Street 1:2323 N CASALOMA DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8284
Practice Address - Country:US
Practice Address - Phone:920-730-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI537026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40802500Medicaid