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General NPI Number Information
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NPI Number | 1962829333
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Entity Type | Individual
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Provider Name | TAMI DEE UNSETH COTA/L
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Gender | Female
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 11/02/2018
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Provider Practice Location Address
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Address Line | 911 3RD ST W
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City | ASHLAND
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State | WI
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Zip | 54806-1311
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Country | US
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Telephone | 715-682-8172
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 103
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City | IRON RIVER
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State | WI
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Zip | 54847-0103
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Country | US
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Telephone | 715-292-5889
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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 | 5053-27
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License Number State | WI
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