Healthcare Provider Details

I. General information

NPI: 1366190043
Provider Name (Legal Business Name): TOENNIES THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2022
Last Update Date: 03/12/2022
Certification Date: 03/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 W SHAKESPEARE DR
VALPARAISO IN
46385-7979
US

IV. Provider business mailing address

18 W SHAKESPEARE DR
VALPARAISO IN
46385-7979
US

V. Phone/Fax

Practice location:
  • Phone: 163-029-1028
  • Fax:
Mailing address:
  • Phone: 163-029-1028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNA TOENNIES
Title or Position: CEO/ OCCUPATIONAL THERAPIST
Credential: MSOTR/L
Phone: 630-291-0282