Healthcare Provider Details

I. General information

NPI: 1568392546
Provider Name (Legal Business Name): JOAN C FARRELL MSOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5606 RUSSETT RD
MADISON WI
53711-3568
US

IV. Provider business mailing address

2110 HARLEY DR
MADISON WI
53711-4352
US

V. Phone/Fax

Practice location:
  • Phone: 608-204-4740
  • Fax:
Mailing address:
  • Phone: 608-886-4602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3531-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: