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Contact Information

KELLY MULDER, COTA
138 E PROSPECT ST
PORT WASHINGTON, WI53074
 Phone: 262-689-5265
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for KELLY MULDER · (Female)

NPI Number 1639507643
Status Active
Credentials COTA (Certified Occupational Therapy Assistant)
Entity Individual
Enumeration date 10/30/2013
Last updated 11/12/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 5045-27
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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