Provider Demographics
NPI:1497946834
Name:HINZ, TERESA JEAN (CRT)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:JEAN
Last Name:HINZ
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:JEAN
Other - Last Name:HINZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRT
Mailing Address - Street 1:8575 W FOREST HOME AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-3417
Mailing Address - Country:US
Mailing Address - Phone:414-425-8400
Mailing Address - Fax:414-425-8449
Practice Address - Street 1:8575 W FOREST HOME AVE STE 140
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-3417
Practice Address - Country:US
Practice Address - Phone:414-425-8400
Practice Address - Fax:414-425-8449
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3523028227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified