# FUNCTIONAL DESIGNS & SOLUTIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104436658
- **Authorized official:** NICOLE RAE SLETTEN (OTR/CEO)
- **Authorized official phone:** (608) 408-8692

## Contact information

- **Practice address:** N9581 FENSKE ROAD, DALTON, WI 53926
- **Practice address phone:** (608) 408-8692
- **Mailing address:** N9581 FENSKE ROAD, DALTON, WI 53926
- **Mailing address phone:** (608) 408-8692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 224ZE0001X | Environmental Modification Occupational Therapy Assistant | — | NULL | — |
| 224ZE0001X | Environmental Modification Occupational Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 225XE0001X | Environmental Modification Occupational Therapist | — | NULL | Yes |
| 225XE0001X | Environmental Modification Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/08/2020
- **Last updated:** 05/24/2021