Kirsten Corinne Wilson, COTA
Individual provider Active NPI Occupational Therapy Assistant · Weyauwega, WI
NPI 1154533909 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154533909
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 991-027 (WI)
- Practice address
- 717 E Alfred St
Weyauwega, WI 54983-9024 - Phone
- (920) 867-3121
- NPI assigned
- May 4, 2007
- 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 |
|---|---|---|---|
| 991-027 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 991-027 | WI | Yes |
Addresses
Primary practice location
717 E Alfred St
Weyauwega, WI 54983-9024
Mailing address
8789 Edgewater RDG
Omro, WI 54963-9800
Phone (920) 685-6121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40760700 | Medicaid | WI |
Other providers in Weyauwega, WI
- Waupaca Area Ambulance, LTD.
- Cynthia May Wendt
- Weyauwega-Fremont School District
- Todd William Wild
- William J Twohig DDS LLC
- Janine Rene Wurzer
- Sarah Elizabeth Zimmermann
All providers in Weyauwega, 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 Jul 8, 2007. 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.