Provider Demographics
NPI:1891008793
Name:BILGER, THERESA CHRISTY (COTA)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:CHRISTY
Last Name:BILGER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-4095
Mailing Address - Country:US
Mailing Address - Phone:765-662-0490
Mailing Address - Fax:765-662-0853
Practice Address - Street 1:418 E 3RD ST
Practice Address - Street 2:SUITE A
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-4095
Practice Address - Country:US
Practice Address - Phone:765-662-0490
Practice Address - Fax:765-662-0853
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001688A172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker