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General NPI Number Information
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NPI Number | 1053968081
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Entity Type | Individual
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Provider Name | ANASTASIA PITZEN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 1915 N 34TH ST
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City | SUPERIOR
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State | WI
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Zip | 54880-5575
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Country | US
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Telephone | 715-399-3287
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Fax |
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Provider Business Mailing Address
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Address Line | 10653 WAYZATA BLVD STE 200
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City | MINNETONKA
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State | MN
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Zip | 55305-1543
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 105947
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6592-26
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License Number State | WI
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