Provider Demographics
NPI:1740489384
Name:TEUT, TAMI MICHELLE (OTR/L)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:MICHELLE
Last Name:TEUT
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 1:18932 U ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-4108
Mailing Address - Country:US
Mailing Address - Phone:402-490-4854
Mailing Address - Fax:402-884-3766
Practice Address - Street 1:7300 GRACELAND DRIVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134
Practice Address - Country:US
Practice Address - Phone:402-572-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE623225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist