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NPI Code Detail

MEDICARE: CAROLINE ROBERTS

MEDICARE: CAROLINE ROBERTS
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 Therapist

General Provider Information

NPI Number : 1922512276
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE ROBERTS
Provider Business Mailing Address
First Line : 1616 W BENDER RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53209-3802
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1616 W BENDER RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53209-3802
Country : US
Telephone Number : 414-228-8700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2017
Last Update Date : 11/24/2017

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Directions to “ CAROLINE ROBERTS ” Practice Location

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