Kendra Lee Allen, COTA
Individual provider Active NPI Occupational Therapy Assistant · Janesville, WI
NPI 1144557331 · NPPES record last updated Dec 5, 2012
Key facts
- NPI
- 1144557331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 057.003179 (IL)
- Practice address
- 36 S Sumac Dr
Janesville, WI 53545-2135 - Phone
- (608) 751-2029
- NPI assigned
- Nov 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 057.003179 | IL | MD | Occupational Therapy Assistant |
| 4723-027 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 057.003179 | IL | Yes |
| Occupational Therapy Assistant | 224Z00000X | 4723-027 | WI |
Addresses
Primary practice location
36 S Sumac Dr
Janesville, WI 53545-2135
Mailing address
36 S Sumac Dr
Janesville, WI 53545-2135
Phone (608) 751-2029
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 057.003179 | Other | IL | STATE LICENSE |
| 4729-027 | Other | WI | STATE LICENSE |
Other providers in Janesville, WI
- Heidi Alderman
- Muhammad B Alkhan
- Chad Alladin
- Emily Grace Allbee
- Caroline Thadda Allen
- Rachel Diane Allen
- Omar Alnaser
- Giuseppe A Altamore
- Arthur Mark Altbuch
- Amanda Deremo
All providers in Janesville, 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 Dec 5, 2012. 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.