Healthcare Provider Details

I. General information

NPI: 1780251108
Provider Name (Legal Business Name): LENA-MARIA COMPRES OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 LIME KILN RD
GREEN BAY WI
54311-6213
US

IV. Provider business mailing address

2105 E ENTERPRISE AVE STE 113
APPLETON WI
54913-7862
US

V. Phone/Fax

Practice location:
  • Phone: 920-965-4715
  • Fax: 920-569-1520
Mailing address:
  • Phone: 920-560-1194
  • Fax: 920-560-1194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6904-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: