Provider Demographics
NPI:1891448361
Name:CLOUTIER, MARIAH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:CLOUTIER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:
Other - Last Name:ARENDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1601 N JACKSON ST APT 406
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2883
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:475 W RIVER WOODS PKWY
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53212-1081
Practice Address - Country:US
Practice Address - Phone:414-961-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14672-0242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic