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General NPI Number Information
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NPI Number | 1144500323
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Entity Type | Individual
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Provider Name | SALLY J STEINE COTA
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Gender | Female
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Dates
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Enumeration Date | 08/19/2011
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 206 N WILLSON DR
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City | ALTOONA
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State | WI
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Zip | 54720-1274
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Country | US
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Telephone | 715-598-7817
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Fax |
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Provider Business Mailing Address
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Address Line | 3360 GATEWAY RD STE 100
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City | BROOKFIELD
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State | WI
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Zip | 53045-5115
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Country | US
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Telephone | 262-923-7101
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 4818027
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License Number State | WI
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