Provider Demographics
NPI:1518188986
Name:NAPASINDAYAO, AUDREY MUYCO (PT)
Entity Type:Individual
Prefix:MISS
First Name:AUDREY
Middle Name:MUYCO
Last Name:NAPASINDAYAO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 S 12TH ST APT 103
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-7268
Mailing Address - Country:US
Mailing Address - Phone:702-349-9562
Mailing Address - Fax:
Practice Address - Street 1:3613 S 13TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-7253
Practice Address - Country:US
Practice Address - Phone:920-208-2982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36127400Medicaid