Individual
AMY STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5979 SIGGELKOW RD, MC FARLAND, WI 53558-9817
(608) 838-8999
Mailing address
5320 SCHLUTER RD, MONONA, WI 53716-3018
(608) 770-6732
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1911-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42255100
—
WI
Enumeration date
08/13/2009
Last updated
08/13/2009
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