Individual
TAMMIE L BEGOTKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
3271 NORTH ST, EAST TROY, WI 53120-1147
(262) 684-5153
Mailing address
30312 BEACHVIEW LN, WATERFORD, WI 53185-3404
(708) 699-8015
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4882-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4882-026
STATE LICENSE
WI
Enumeration date
06/07/2010
Last updated
06/07/2010
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