Diedre Lynn Armstrong, COTA

Individual provider Active NPI Occupational Therapy Assistant · Viroqua, WI

NPI 1619307477 · NPPES record last updated Aug 12, 2024

Key facts

NPI
1619307477
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
5007-27 (WI)
Practice address
614 S Rock Ave
Viroqua, WI 54665-1936
Phone
(608) 637-2171
NPI assigned
Nov 14, 2013
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

LicenseStateTypeSpecialty
5007-27WIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5007-27 WI Yes

Addresses

Primary practice location

614 S Rock Ave
Viroqua, WI 54665-1936

Mailing address

3210 S Pleasant Dr
Holmen, WI 54636-9164
Phone (608) 780-7087

Other identifiers

IdentifierTypeStateIssuer
5007-27MedicaidWI

Other providers in Viroqua, WI

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

Sources for this page

Verify at the official NPI Registry.