Healthcare Provider Details

I. General information

NPI: 1255868113
Provider Name (Legal Business Name): KATE MARIE VANALSTYNE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE MARIE GIAIMO OT

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SCHEURING RD
DE PERE WI
54115-1701
US

IV. Provider business mailing address

755 SCHEURING RD
DE PERE WI
54115-1701
US

V. Phone/Fax

Practice location:
  • Phone: 920-336-5754
  • Fax:
Mailing address:
  • Phone: 920-336-5754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number379687
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: