Provider Demographics
NPI:1669835542
Name:THIEMER, SHERRY (OTR)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:THIEMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 W NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-2141
Mailing Address - Country:US
Mailing Address - Phone:414-383-8921
Mailing Address - Fax:414-383-9016
Practice Address - Street 1:1527 W. NATIONAL AVENUE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-2141
Practice Address - Country:US
Practice Address - Phone:414-383-8921
Practice Address - Fax:414-383-9016
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI634-26225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health