Provider Demographics
NPI:1356836399
Name:ROESLER, KALI (COTA)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:
Last Name:ROESLER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:KALI
Other - Middle Name:
Other - Last Name:MUTSCHELKNAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1231 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-4847
Mailing Address - Country:US
Mailing Address - Phone:605-760-1833
Mailing Address - Fax:
Practice Address - Street 1:E7404 CR-BB
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665
Practice Address - Country:US
Practice Address - Phone:608-637-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No224ZE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantEnvironmental Modification
No224ZF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantFeeding, Eating & Swallowing