Healthcare Provider Details

I. General information

NPI: 1689506693
Provider Name (Legal Business Name): VALERIA SANTANA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PARK ST
FORT ATKINSON WI
53538-2155
US

IV. Provider business mailing address

506 HILLCREST DR
FORT ATKINSON WI
53538-1132
US

V. Phone/Fax

Practice location:
  • Phone: 920-563-7822
  • Fax:
Mailing address:
  • Phone: 608-239-2374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5016-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: