Provider Demographics
NPI:1316151269
Name:PAPROCKI, DEANN MARIE (OTR)
Entity type:Individual
Prefix:MRS
First Name:DEANN
Middle Name:MARIE
Last Name:PAPROCKI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 E SABLERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8063
Mailing Address - Country:US
Mailing Address - Phone:920-867-3124
Mailing Address - Fax:
Practice Address - Street 1:717 E ALFRED ST
Practice Address - Street 2:
Practice Address - City:WEYAUWEGA
Practice Address - State:WI
Practice Address - Zip Code:54983-9024
Practice Address - Country:US
Practice Address - Phone:920-867-3124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1446026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40782000Medicaid