Provider Demographics
NPI:1598938623
Name:MCGEE, SANDRA ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:MCGEE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51525 SMITH LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BARNES
Mailing Address - State:WI
Mailing Address - Zip Code:54873-4556
Mailing Address - Country:US
Mailing Address - Phone:715-795-2528
Mailing Address - Fax:
Practice Address - Street 1:10775 NYMAN AVE
Practice Address - Street 2:VALLEY OF HAYWARD
Practice Address - City:HAYWARD
Practice Address - State:WI
Practice Address - Zip Code:54843-6484
Practice Address - Country:US
Practice Address - Phone:715-634-2202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3848026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40843500Medicaid