Individual
TARA SOSALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
502 S HIGH ST, RANDOLPH, WI 53956-1499
(920) 326-3171
Mailing address
N764 COUNTY ROAD FF, DALTON, WI 53926-9347
(608) 617-6304
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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