Provider Demographics
NPI:1396900973
Name:ALBA, VICKIE LYNN (OTR CHT)
Entity type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:LYNN
Last Name:ALBA
Suffix:
Gender:F
Credentials:OTR CHT
Other - Prefix:
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Mailing Address - Street 1:2500 N MAYFAIR RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226
Mailing Address - Country:US
Mailing Address - Phone:414-453-7418
Mailing Address - Fax:414-453-7420
Practice Address - Street 1:721 AMERICAN AVE
Practice Address - Street 2:SUITE 411
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188
Practice Address - Country:US
Practice Address - Phone:414-453-7418
Practice Address - Fax:414-453-7420
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1033026225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand