Stacey L Klein, OTA
Individual provider Active NPI Occupational Therapy Assistant · Woodruff, WI
NPI 1467533547 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1467533547
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 1027040 (WI)
- Practice address
- 240 Maple Street
Woodruff, WI 54568-0470 - Phone
- (715) 356-8000
- NPI assigned
- Oct 17, 2006
- 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 |
|---|---|---|---|
| 1027040 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1027040 | WI | Yes |
Addresses
Primary practice location
240 Maple Street
Woodruff, WI 54568-0470
Mailing address
240 Maple Street
PO Box 470
Woodruff, WI 54568-0470
Phone (715) 356-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40847000 | Medicaid | WI |
Other names
- Stacey L Sangiacomo
Other providers in Woodruff, WI
- Joanne C Kemnitz
- Sara E Keuler
- Macie Khan
- Vijai Paul Khan
- Kristin King
- Cassie Elizabeth Kleinhans
- Brook Kmiecik
- Frederick Knoch
- Shirlee Ann Knox
- Taylor Grace Koehnen
All providers in Woodruff, 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 9, 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.