Katie M Cunningham, COTA

Individual provider Active NPI Occupational Therapy Assistant · Ashland, WI

NPI 1679019947 · NPPES record last updated Jan 11, 2017

Key facts

NPI
1679019947
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
5293-27 (WI)
Practice address
1635 Maple LN
Ashland, WI 54806-3610
Phone
(715) 685-5400
Fax
(715) 685-5102
NPI assigned
Jan 11, 2017
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
5293-27WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5293-27 WI Yes

Addresses

Primary practice location

1635 Maple LN
Ashland, WI 54806-3610

Mailing address

1635 Maple LN
Ashland, WI 54806-3610
Phone (715) 685-5400

Other providers in Ashland, WI

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

Sources for this page

Verify at the official NPI Registry.