Thibodeaux, Amy M

Thibodeaux, Amy M is an individual health care provider with primary practice located at 1160 Kepler Dr , Green Bay WI 54311-8321. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Thibodeaux, Amy M can be contacted via phone (920) 288-5500.

Contact Information

Primary practice address
1160 Kepler Dr Green Bay WI 54311-8321
Phone: (920) 288-5500
Fax: (920) 288-5510
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 2801-26 Wisconsin

Profile Details

NPI number 1285003731
LBN Legal business name Thibodeaux, Amy M
Credentials Registered Occupational Therapist (OTR)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2015
Last updated Sep 20th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285003731 NPPES
Wisconsin MEDICAID 40789200

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