MEDICARE: MRS. AMANDA WILMOT C.O.T.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	1732-027	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1732-027	OTHER	WI	STATE OF WI CREDENTIALS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1044814	OTHER	WI	NATIONAL BOARD FOR CERT.

General Provider Information

NPI Number	:	1174539951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA WILMOT C.O.T.A.

Provider Business Mailing Address
First Line	:	W9843 OLD 14 RD
Second Line	:
City	:	LADYSMITH
State	:	WI
Zip	:	54848-9516
Country	:	US
Telephone Number	:	715-415-2747
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 W PARK AVE
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-3399
Country	:	US
Telephone Number	:	715-720-2053
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	01/07/2026

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