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Contact Information

TAMMIE E DEMICCO, COTA
1922 COUNTY RD. NN
ELKHORN, WI53121
 Phone: 262-741-3630
 Fax: 262-743-1855
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for TAMMIE E DEMICCO · (Female)

NPI # 1245458140
Status Active
Credentials COTA (Certified Occupational Therapy Assistant)
Entity Individual
Enumeration date 04/23/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 1812-027
  • WI Medicaid 40850800
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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