Pamela L Fraser, COTA
Individual provider Active NPI Occupational Therapy Assistant · Greendale, WI
NPI 1104093210 · NPPES record last updated May 8, 2008
Key facts
- NPI
- 1104093210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 1013027 (WI)
- Practice address
- 5404 W Loomis Rd
Greendale, WI 53129-1411 - Phone
- (414) 421-0088
- NPI assigned
- May 8, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1013027 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1013027 | WI | Yes |
Addresses
Primary practice location
5404 W Loomis Rd
Greendale, WI 53129-1411
Mailing address
4115 S Quincy Ave
Milwaukee, WI 53207-4471
Phone (414) 481-0284
Other providers in Greendale, WI
- April Fischer
- Monica M Flesch
- Stephanie Claire Floyd
- Kathryn Marie Forecki
- Colleen Fraley
- Michael Freitag
- Dana Friske
- Brenda Furru
- Theresa Gager
- Alfredo Aguilar Garcia
All providers in Greendale, WI · Occupational Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.