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Contact Information

MACKINZIE L VERDEGAN, COTA
2217 DUNCAN ROAD
BLOOMER, WI54724
 Phone: 715-641-0510
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for MACKINZIE L VERDEGAN · (Female)

NPI Number 1326713694
Status Active
Credentials COTA (Certified Occupational Therapy Assistant)
Entity Individual
Enumeration date 08/10/2021
Last updated 08/22/2025 - About 10 months ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 5795-27
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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