Healthcare Provider Details

I. General information

NPI: 1376459792
Provider Name (Legal Business Name): LINDSEY ANN TRIMMEL COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 N THEIS LN
PORT WASHINGTON WI
53074-1245
US

IV. Provider business mailing address

6920 N CRESTWOOD DR
GLENDALE WI
53209-2722
US

V. Phone/Fax

Practice location:
  • Phone: 262-268-6000
  • Fax:
Mailing address:
  • Phone: 414-964-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: