Healthcare Provider Details

I. General information

NPI: 1598658551
Provider Name (Legal Business Name): JAMES MICHAEL CAMERON OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 S 16TH ST
MILWAUKEE WI
53215-4526
US

IV. Provider business mailing address

348 E OKLAHOMA AVE APT 7
MILWAUKEE WI
53207-2657
US

V. Phone/Fax

Practice location:
  • Phone: 414-647-7444
  • Fax:
Mailing address:
  • Phone: 414-813-3057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number8416
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: