MRS. SUSAN M DIEDRICK (NPI# 1235452582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235452582 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN M DIEDRICK |
| Practice Address |
845 S Main St Suite 120 Fond Du Lac WI 54935-6174 |
| Practice Telephone | 9203220447 |
| Practice Fax Number | 9203221362 |
| Mailing Telephone | 9203220447 |
| Mailing Fax Number | 9203221362 |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2010-03-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 225-26 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
845 S MAIN ST SUITE 120 |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-6174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528482684 | Matthew Melotte | Physical Therapist | 845 S Main St, Suite 120, Fond Du Lac, WI 54935-6116 | 2014-02-10 |
| 1558604165 | David G Moehn | Speech-Language Pathologist | 845 S Main St, Suite 120, Fond Du Lac, WI 54935-6174 | 2013-04-02 |
| 1306195334 | Katie Marie Radig | Occupational Therapist | 845 S Main St, Fond Du Lac, WI 54935-6174 | 2012-09-06 |
| 1437423993 | Vicki Marie Denzin | Physical Therapist | 845 S Main St, Suite 120, Fond Du Lac, WI 54935-6174 | 2012-03-01 |
| 1588831770 | Jennifer Ann Hansen | Physical Therapist | 845 S Main St, Fond Du Lac, WI 54935 | 2008-05-15 |
| 1164634622 | Michelle Lynn Halfman | Speech-Language Pathologist | 845 S Main St, Fond Du Lac, WI 54935-6174 | 2007-05-04 |
| 1053430991 | Associated Family Dentistry LLC | Dentist | 845 S Main St, Suite 130, Fond Du Lac, WI 54935-6174 | 2007-03-29 |
| 1134297070 | Staci Christine Polishinski | Physical Therapy Assistant | 845 S Main St, Fond Du Lac, WI 54935-6174 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467419218 | Julie Meincke | Occupational Therapist | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2006-04-26 |
| 1790383891 | Lisa Simanek | Occupational Therapist | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2020-10-12 |
| 1942832811 | Matthew Olig | Occupational Therapist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-02-10 |
| 1427511310 | Samantha Nicole Dykstra | Occupational Therapist | 430 E Division St, Fond Du Lac, WI 54935-4597 | 2019-04-09 |
| 1619441037 | Wilhelmina Swanson | Occupational Therapist | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2019-01-18 |
| 1194290437 | Emily Schneider | Occupational Therapist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2018-10-12 |
| 1124507298 | Katherine Kristine Waltenberry | Occupational Therapist | 430 E Division St, Fond Du Lac, WI 54935-4597 | 2018-08-09 |
| 1669969200 | Brittany Schueller | Occupational Therapist | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2018-04-19 |
| 1154848083 | Sonja Lemke | Occupational Therapist | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2017-08-22 |
| 1891218418 | Stephanie Nicole Fry | Occupational Therapist | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2017-07-25 |
| Find all providers in FOND DU LAC | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.