Individual
AMANDA LYNN BUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2512 NEW PINE DRIVE, ALTOONA, WI 54720
(715) 833-0400
Mailing address
12668 43RD AVE, CHIPPEWA FALLS, WI 54729
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1869-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40865700
—
WI
Enumeration date
05/09/2007
Last updated
07/08/2007
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