Provider Demographics
NPI:1881326114
Name:THORSON, SYDNEY (OTR/L)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:THORSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:REARICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2039 N LAKE DR APT 18
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1354
Mailing Address - Country:US
Mailing Address - Phone:414-403-2092
Mailing Address - Fax:
Practice Address - Street 1:6700 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-3919
Practice Address - Country:US
Practice Address - Phone:414-351-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7107225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist