Provider Demographics
NPI:1992946453
Name:DEVLIN, JOAN B (OTR)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:B
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:B
Other - Last Name:DEVLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:W173N10915 BERNIE'S WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-4043
Mailing Address - Country:US
Mailing Address - Phone:126-250-9330
Mailing Address - Fax:126-225-1735
Practice Address - Street 1:W173N10915 BERNIE'S WAY
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-4043
Practice Address - Country:US
Practice Address - Phone:126-250-9330
Practice Address - Fax:126-225-1735
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1740026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist