Healthcare Provider Details

I. General information

NPI: 1235062761
Provider Name (Legal Business Name): THERESA JOAN DELVEAUX MA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 MILES ST
CHIPPEWA FALLS WI
54729-1998
US

IV. Provider business mailing address

129 N WASHINGTON ST
MONDOVI WI
54755-1206
US

V. Phone/Fax

Practice location:
  • Phone: 715-726-2417
  • Fax:
Mailing address:
  • Phone: 651-231-9515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number854026
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: