=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780251108
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LENA-MARIA COMPRES OTD, OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2021
-----------------------------------------------------
Last Update Date | 07/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2223 LIME KILN RD
-----------------------------------------------------
City | GREEN BAY
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54311-6213
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-965-4715
-----------------------------------------------------
Fax | 920-569-1520
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2105 E ENTERPRISE AVE STE 113
-----------------------------------------------------
City | APPLETON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54913-7862
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-560-1194
-----------------------------------------------------
Fax | 920-560-1194
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 6904-26
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------