Provider Demographics
NPI:1841539020
Name:BROWN, TRICIA (OTR/L)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
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 1:311 MEADOW VIEW RD
Mailing Address - Street 2:MOUNT HOREB
Mailing Address - City:MOUNT HOREB
Mailing Address - State:WI
Mailing Address - Zip Code:53572-1463
Mailing Address - Country:US
Mailing Address - Phone:920-912-2213
Mailing Address - Fax:
Practice Address - Street 1:2111 ADDERBURY CIR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-3901
Practice Address - Country:US
Practice Address - Phone:920-912-2213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5250-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist