Provider Demographics
NPI:1952340952
Name:COUGHLIN-BECKER, CATHLEEN ANN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:ANN
Last Name:COUGHLIN-BECKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DREXEL TOWN SQUARE HEALTH CENTER
Mailing Address - Street 2:7901 S. 6TH ST
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-2010
Mailing Address - Country:US
Mailing Address - Phone:414-346-8000
Mailing Address - Fax:
Practice Address - Street 1:DREXEL TOWN SQUARE
Practice Address - Street 2:7901 S. 6TH ST
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-2010
Practice Address - Country:US
Practice Address - Phone:414-346-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1464225X00000X
WI1464026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40870400Medicaid
WI1952340952Medicaid