Provider Demographics
NPI:1639343171
Name:STRAMPE, SUZANNE VIRGINIA (COTA)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:VIRGINIA
Last Name:STRAMPE
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:S2170 LUEDTKE ROAD
Mailing Address - Street 2:STE A
Mailing Address - City:LA VALLE
Mailing Address - State:WI
Mailing Address - Zip Code:53941
Mailing Address - Country:US
Mailing Address - Phone:608-524-6725
Mailing Address - Fax:
Practice Address - Street 1:S2170 LUEDTKE RD
Practice Address - Street 2:STE A
Practice Address - City:LA VALLE
Practice Address - State:WI
Practice Address - Zip Code:53941
Practice Address - Country:US
Practice Address - Phone:608-524-6725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1575-027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant