Provider Demographics
NPI:1336785633
Name:STRANGSTALIEN, BETH A
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:STRANGSTALIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 S CHESTNUT ST APT 103E
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53818-3700
Mailing Address - Country:US
Mailing Address - Phone:608-422-1566
Mailing Address - Fax:
Practice Address - Street 1:111 S JEFFERSON ST FL 2
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813-1672
Practice Address - Country:US
Practice Address - Phone:608-723-6416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI562827224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant