Michelle L Sislo, COTA

Individual provider Active NPI Occupational Therapy Assistant · Colby, WI

NPI 1659498285 · NPPES record last updated Oct 11, 2012

Key facts

NPI
1659498285
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
1038-27 (WI)
Practice address
702 W Dolf St
Colby, WI 54421-9604
Phone
(715) 223-2352
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
1038-27WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Wausau LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1038-27 WI Yes

Addresses

Primary practice location

702 W Dolf St
Colby, WI 54421-9604

Mailing address

N2092 Gibson Dr
Medford, WI 54451-9561

Other identifiers

IdentifierTypeStateIssuer
40756900MedicaidWI

Other providers in Colby, WI

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

Sources for this page

Verify at the official NPI Registry.