Healthcare Provider Details

I. General information

NPI: 1841850401
Provider Name (Legal Business Name): DIANE ARANDA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 W MITCHELL ST STE 300B
MILWAUKEE WI
53215-1748
US

IV. Provider business mailing address

4111 W MITCHELL ST STE 300B
MILWAUKEE WI
53215-1748
US

V. Phone/Fax

Practice location:
  • Phone: 414-643-3860
  • Fax: 414-643-3871
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number276326
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: