MEDICARE: MS. TERESA ANN BODWELL OTR

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
1	225X00000X	Occupational Therapist	6319	WI

General Provider Information

NPI Number	:	1700370723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERESA ANN BODWELL OTR

Provider Business Mailing Address
First Line	:	3408 REGENT ST APT A
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481-2254
Country	:	US
Telephone Number	:	515-571-1503
Fax Number	:

Provider Business Practice Location Address
First Line	:	3408 REGENT ST APT A
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481-2254
Country	:	US
Telephone Number	:	515-571-1503
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	04/17/2026

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