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NPI Code Detail

MEDICARE: HEIDI GULACHEK OTR/L

MEDICARE: HEIDI GULACHEK 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
1225X00000XOccupational Therapist7025-26WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17025-26OTHERWISTATE OF WISCONSIN LICENSE

General Provider Information

NPI Number : 1770153652
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI GULACHEK OTR/L
Provider Business Mailing Address
First Line : 6674 RONALD REAGAN AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-2395
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6674 RONALD REAGAN AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-2395
Country : US
Telephone Number : 608-556-6120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2021
Last Update Date : 11/26/2024

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Directions to “ HEIDI GULACHEK OTR/L” Practice Location

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