Provider Demographics
NPI:1871249813
Name:RAHN, JILL (COTA/L)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:RAHN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:WEISENSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3200 COUNTY ROAD T
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-6435
Mailing Address - Country:US
Mailing Address - Phone:608-245-0928
Mailing Address - Fax:
Practice Address - Street 1:700 CLARK ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:WI
Practice Address - Zip Code:53555-1010
Practice Address - Country:US
Practice Address - Phone:608-592-3241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant