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NPI Code Detail

MEDICARE: MS. THERESA ANNE SCHILLREFF MS OTR/L

MEDICARE: MS. THERESA ANNE SCHILLREFF MS OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171000000XMilitary Health Care Provider46TR00348000NJ
2225X00000XOccupational TherapistOC009966PA

General Provider Information

NPI Number : 1053369108
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. THERESA ANNE SCHILLREFF MS OTR/L
Provider Business Mailing Address
First Line : 3220 KELLERTON PL
Second Line :
City : WILMINGTON
State : NC
Zip : 28409-4220
Country : US
Telephone Number : 609-602-2128
Fax Number :
Provider Business Practice Location Address
First Line : 1705 GARDNER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28405-8873
Country : US
Telephone Number : 910-343-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 08/26/2019

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