Provider Demographics
NPI:1710108238
Name:ZEIER, EILEEN M (OTRL)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:ZEIER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-1140
Mailing Address - Country:US
Mailing Address - Phone:608-837-9157
Mailing Address - Fax:
Practice Address - Street 1:901 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:LAKE MILLS
Practice Address - State:WI
Practice Address - Zip Code:53551-1335
Practice Address - Country:US
Practice Address - Phone:920-648-8344
Practice Address - Fax:920-648-3441
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
WI3742026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40873200Medicaid