Provider Demographics
NPI:1790006104
Name:THATCHER, DUREE DRISCOLL (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:DUREE
Middle Name:DRISCOLL
Last Name:THATCHER
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2848 WELLINGTON DR E
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-0775
Mailing Address - Country:US
Mailing Address - Phone:715-552-1035
Mailing Address - Fax:715-552-4567
Practice Address - Street 1:3656 MALL DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-7634
Practice Address - Country:US
Practice Address - Phone:715-552-1035
Practice Address - Fax:715-552-4567
Is Sole Proprietor?:No
Enumeration Date:2010-06-20
Last Update Date:2010-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4792-026225X00000X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist