Healthcare Provider Details

I. General information

NPI: 1982568275
Provider Name (Legal Business Name): TALYA LOKEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 BUTLER AVE
OSHKOSH WI
54901-8149
US

IV. Provider business mailing address

W4596 VALLEY DR
FOND DU LAC WI
54937-9660
US

V. Phone/Fax

Practice location:
  • Phone: 920-237-6300
  • Fax:
Mailing address:
  • Phone: 920-517-1775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9058-26
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: