Mary J. Farner-Oren, COTA
Individual provider Active NPI Occupational Therapy Assistant · Edgerton, WI
NPI 1255464285 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255464285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 404-027 (WI)
- Practice address
- 11 Blanchard St
Edgerton, WI 53534-1501 - Phone
- (608) 884-8831
- NPI assigned
- Mar 13, 2007
- 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 |
|---|---|---|---|
| 404-027 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 404-027 | WI | Yes |
Addresses
Primary practice location
11 Blanchard St
Edgerton, WI 53534-1501
Mailing address
11 Blanchard St
Edgerton, WI 53534-1501
Phone (608) 884-8831
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 404-027 | Other | WI | STATE LICIENCE |
Other providers in Edgerton, WI
- Edgerton Hospital and Health Services, Inc
- Edgerton Hospital and Health Services, Inc.
- Andrew John Eliszewski
- Crystal J Endres
- Esh Enterprises LLC
- Forward Physical Therapy LLC
- Fox Chiropractic, LLC
- James Michael Fox
- Justin C. Frey
- Dawn Dorothea Friedrichslpn
All providers in Edgerton, 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.