Individual
ELIZABETH J ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4502 MILWAUKEE ST, MADISON, WI 53714-2133
(608) 249-2137
Mailing address
4502 MILWAUKEE ST, MADISON, WI 53714-2133
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4753-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100009994
—
WI
Enumeration date
06/21/2010
Last updated
04/05/2017
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