Provider Demographics
NPI:1386523207
Name:MATERNA, MORGAN ELIZABETH ANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELIZABETH ANNE
Last Name:MATERNA
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 1:19601 W BLUEMOUND RD STE 120
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-5974
Mailing Address - Country:US
Mailing Address - Phone:252-771-0065
Mailing Address - Fax:
Practice Address - Street 1:19601 W BLUEMOUND RD STE 120
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-5974
Practice Address - Country:US
Practice Address - Phone:262-771-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8970-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist