Provider Demographics
NPI:1891116240
Name:ROCHELEAU, CHERYL (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:ROCHELEAU
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 1:4003 CARL ST
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-2287
Mailing Address - Country:US
Mailing Address - Phone:603-733-6710
Mailing Address - Fax:
Practice Address - Street 1:4003 CARL ST
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-2287
Practice Address - Country:US
Practice Address - Phone:603-733-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-01
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5397-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH5339OtherSTATE OF NEW HAMPSHIRE
WI5397-26OtherSTATE OF WISCONSIN