Provider Demographics
NPI:1265609382
Name:GULLING, KAREN JANE (COTA)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:JANE
Last Name:GULLING
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 1:73 N MAIN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-1553
Mailing Address - Country:US
Mailing Address - Phone:262-224-1885
Mailing Address - Fax:
Practice Address - Street 1:73 N MAIN ST APT 3
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-1553
Practice Address - Country:US
Practice Address - Phone:262-224-1885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI781-027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant