Provider Demographics
NPI:1679362099
Name:BATES, AMELIA MARGARET (OTR/L)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:MARGARET
Last Name:BATES
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W5957 DAISY CT
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-7470
Mailing Address - Country:US
Mailing Address - Phone:920-224-4765
Mailing Address - Fax:
Practice Address - Street 1:801 BRAXTON PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1415
Practice Address - Country:US
Practice Address - Phone:608-260-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8877-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist