Sandra A Bassett

Individual provider Active NPI Occupational Therapy Assistant · Wausau, WI

NPI 1124355169 · NPPES record last updated Nov 12, 2009

Key facts

NPI
1124355169
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
398-027 (WI)
Practice address
1100 Lake View Dr
Wausau, WI 54403-6785
Phone
(715) 848-4600
Fax
(715) 845-5398
NPI assigned
Nov 12, 2009
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

LicenseStateTypeSpecialty
398-027WIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 398-027 WI Yes

Addresses

Primary practice location

1100 Lake View Dr
Wausau, WI 54403-6785

Mailing address

1100 Lake View Dr
Wausau, WI 54403-6785
Phone (715) 848-4600

Other identifiers

IdentifierTypeStateIssuer
40721900MedicaidWI

Other providers in Wausau, WI

All providers in Wausau, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.