MEDICARE: MRS. THERESA JOAN DELVEAUX MA OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	854026	WI

General Provider Information

NPI Number	:	1235062761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THERESA JOAN DELVEAUX MA OTR/L

Provider Business Mailing Address
First Line	:	129 N WASHINGTON ST
Second Line	:
City	:	MONDOVI
State	:	WI
Zip	:	54755-1206
Country	:	US
Telephone Number	:	651-231-9515
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 MILES ST
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-1998
Country	:	US
Telephone Number	:	715-726-2417
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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