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NPI Code Detail

MEDICARE: MRS. AMY JO BRASHI OTA

MEDICARE: MRS. AMY JO BRASHI OTA
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
1224Z00000XOccupational Therapy Assistant170827WI

General Provider Information

NPI Number : 1366732075
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY JO BRASHI OTA
Provider Business Mailing Address
First Line : 1836 BUCKINGHAM RD
Second Line :
City : STOUGHTON
State : WI
Zip : 53589-4855
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8301 OLD SAUK RD
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-4389
Country : US
Telephone Number : 608-668-8866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2011
Last Update Date : 04/14/2011

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