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General NPI Number Information
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NPI Number | 1699474031
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Entity Type | Individual
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Provider Name | MARIN STAUFFACHER COTA
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Gender | Female
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 101 E MILWAUKEE ST STE 507
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City | JANESVILLE
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State | WI
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Zip | 53545-3004
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Country | US
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Telephone | 608-728-7774
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Fax | 608-621-3804
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Provider Business Mailing Address
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Address Line | 101 E MILWAUKEE ST STE 507
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City | JANESVILLE
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State | WI
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Zip | 53545-3004
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Country | US
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Telephone | 608-728-7774
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Fax | 608-621-3804
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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 | 7279-27
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | RBT-23-259875
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License Number State | WI
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