Gail Bliss, COTA

Individual provider Active NPI Occupational Therapy Assistant · Stoughton, WI

NPI 1962887539 · NPPES record last updated Jul 24, 2015

Key facts

NPI
1962887539
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
4673 - 027 (WI)
Practice address
400 N Morris St
Rehab Dept
Stoughton, WI 53589-1857
Phone
(608) 873-5651
NPI assigned
Jul 24, 2015
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
4673 - 027WIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4673 - 027 WI Yes

Addresses

Primary practice location

400 N Morris St
Rehab Dept
Stoughton, WI 53589-1857

Mailing address

5309 Regent St
Madison, WI 53705-4626
Phone (608) 231-3511

Other providers in Stoughton, WI

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

Sources for this page

Verify at the official NPI Registry.