Provider Demographics
NPI:1285808147
Name:MCCARTEN, ALICIA COREEN (OTR)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:COREEN
Last Name:MCCARTEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:COREEN
Other - Last Name:BLEICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1100 COMMERCE DR
Mailing Address - Street 2:SUITE114
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-3700
Mailing Address - Country:US
Mailing Address - Phone:262-886-3431
Mailing Address - Fax:
Practice Address - Street 1:1100 COMMERCE DR
Practice Address - Street 2:SUITE114
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-3700
Practice Address - Country:US
Practice Address - Phone:262-886-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3555-026174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist