Provider Demographics
NPI:1093103293
Name:FICHTER, MARGARET JO (COTA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JO
Last Name:FICHTER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E11439 HWY 159
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-9217
Mailing Address - Country:US
Mailing Address - Phone:608-434-6999
Mailing Address - Fax:
Practice Address - Street 1:E11439 HWY 159
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-9217
Practice Address - Country:US
Practice Address - Phone:608-434-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOTA-1196171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor