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General NPI Number Information
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NPI Number | 1952725129
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Entity Type | Individual
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Provider Name | JAIME PATERNOSTER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/09/2014
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Last Update Date | 02/09/2014
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Provider Practice Location Address
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Address Line | 501 LAKE AVE COURTHOUSE LOWER LEVEL
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City | FLORENCE
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State | WI
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Zip | 54121-8805
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Country | US
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Telephone | 715-528-3296
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Fax |
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Provider Business Mailing Address
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Address Line | W8095 OAKRIDGE RD
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-9341
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Country | US
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Telephone | 906-828-1263
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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 | 3992-026
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License Number State | WI
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