Provider Demographics
NPI:1518158195
Name:SCHEEL, SARA R (OT)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:R
Last Name:SCHEEL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 S SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-3274
Mailing Address - Country:US
Mailing Address - Phone:920-865-6415
Mailing Address - Fax:
Practice Address - Street 1:644 S SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-3274
Practice Address - Country:US
Practice Address - Phone:920-865-6415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4212-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41042500Medicaid