Provider Demographics
NPI:1578736302
Name:STREI, JANICE MARY (COTA)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MARY
Last Name:STREI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 CORMORANT LN
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-4015
Mailing Address - Country:US
Mailing Address - Phone:920-434-3434
Mailing Address - Fax:
Practice Address - Street 1:2100 CORMORANT LN
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-4015
Practice Address - Country:US
Practice Address - Phone:920-434-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI907-027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant