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General NPI Number Information
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NPI Number | 1265888796
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Entity Type | Individual
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Provider Name | KATIE ZAVODNY-OLSON
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Gender | Female
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | N818 STATE HIGHWAY 35
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City | STODDARD
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State | WI
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Zip | 54658-9777
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Country | US
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Telephone | 715-505-6017
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Fax |
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Provider Business Mailing Address
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Address Line | 2346 STATE ROAD 16
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City | LA CROSSE
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State | WI
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Zip | 54601-3013
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Country | US
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Telephone | 715-505-6017
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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 |
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 5211
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License Number State | WI
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