Kimberly Leis, OTA
Individual provider Active NPI Occupational Therapy Assistant · Elroy, WI
NPI 1477942191 · NPPES record last updated Jan 19, 2015
Key facts
- NPI
- 1477942191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 5084-27 (WI)
- Practice address
- 307 Royall Ave
Elroy, WI 53929-1044 - Phone
- (608) 462-8491
- NPI assigned
- Jan 19, 2015
- 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 |
|---|---|---|---|
| 5084-27 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5084-27 | WI | Yes |
Addresses
Primary practice location
307 Royall Ave
Elroy, WI 53929-1044
Mailing address
24352 County Highway M
Wilton, WI 54670-6012
Phone (608) 797-6721
Other providers in Elroy, WI
- Daisy Faith Hansen
- Heritage Elroy Operations LLC
- Jack a Besant Inc
- Christopher J. Karas
- Gina Klean
- MBMC Mauston Phillips, LLC
- Mile Bluff Clinic, LLP
- Mile Bluff Medical Center Inc
- Moiya Lyn Murphy
- NSH Elroy LLC
All providers in Elroy, 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 Jan 19, 2015. 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.