Provider Demographics
NPI:1518138718
Name:SCHEERER, BONNIE MAE (OTR)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:MAE
Last Name:SCHEERER
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:W2556 AUBURN ASHFORD DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSPORT
Mailing Address - State:WI
Mailing Address - Zip Code:53010-2515
Mailing Address - Country:US
Mailing Address - Phone:920-980-0785
Mailing Address - Fax:
Practice Address - Street 1:4605 VALDRES SPRINGS COURT
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476
Practice Address - Country:US
Practice Address - Phone:715-393-0419
Practice Address - Fax:715-393-0435
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3387-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40836100Medicaid