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General NPI Number Information
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NPI Number | 1619806981
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Entity Type | Individual
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Provider Name | CARRIE KOHLSTEDT
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Gender | Female
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 2600 E BOLIVAR AVE
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City | ST FRANCIS
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State | WI
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Zip | 53235-5434
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Country | US
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Telephone | 414-486-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 4367 S PACKARD AVE
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City | CUDAHY
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State | WI
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Zip | 53110-1163
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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 |
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License Number State | WI
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