Provider Demographics
NPI:1194035337
Name:SCHULZ, AMY JO (COTA)
Entity Type:Individual
Prefix:
First Name:AMY JO
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:AMY JO
Other - Middle Name:
Other - Last Name:JOSWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17280 W NORTH AVE
Mailing Address - Street 2:#104
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4366
Mailing Address - Country:US
Mailing Address - Phone:262-780-0707
Mailing Address - Fax:
Practice Address - Street 1:17280 W NORTH AVE
Practice Address - Street 2:#104
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4366
Practice Address - Country:US
Practice Address - Phone:262-780-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI408224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant