Provider Demographics
NPI:1760899579
Name:TENHOOR, REBECCA (OTR/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TENHOOR
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 1:211 CORPORATE DR
Mailing Address - Street 2:PO BOX 188
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-3119
Mailing Address - Country:US
Mailing Address - Phone:920-885-0680
Mailing Address - Fax:920-885-0684
Practice Address - Street 1:1486 W MEQUON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3268
Practice Address - Country:US
Practice Address - Phone:262-241-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5456-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist