Tracy Catherine Strom, COTA

Individual provider Active NPI Occupational Therapy Assistant · Augusta, WI

NPI 1508064197 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508064197
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
1685-027 (WI)
Practice address
215 E Brown St
Augusta, WI 54722-9346
Phone
(715) 286-2266
NPI assigned
Jul 5, 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

LicenseStateTypeSpecialty
1685-027WIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1685-027 WI Yes

Addresses

Primary practice location

215 E Brown St
Augusta, WI 54722-9346

Mailing address

3120 Venus Ave
Eau Claire, WI 54703-0919

Other identifiers

IdentifierTypeStateIssuer
40899100MedicaidWI

Other providers in Augusta, WI

All providers in Augusta, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.