Basic Information
| Provider Information | |||||||||
| NPI: | 1891008793 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BILGER | ||||||||
| FirstName: | THERESA | ||||||||
| MiddleName: | CHRISTY | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | COTA | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 418 E 3RD ST | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | IN | ||||||||
| PostalCode: | 469524095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656620490 | ||||||||
| FaxNumber: | 7656620853 | ||||||||
| Practice Location | |||||||||
| Address1: | 418 E 3RD ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MARION | ||||||||
| State: | IN | ||||||||
| PostalCode: | 469524095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656620490 | ||||||||
| FaxNumber: | 7656620853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2010 | ||||||||
| LastUpdateDate: | 07/20/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | 32001688A | IN | Y | Other Service Providers | Community Health Worker |
No ID Information.