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Contact Information

JENNIE LAUE, COTA/L
559 MICHIGAN ST
OMRO, WI54963-1254
 Phone: 719-258-0072
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for JENNIE LAUE · (Female)

NPI # 1811359458
Status Active
Credentials COTA/L (Licensed Certified Occupational Therapy Assistant )
Entity Individual
Enumeration date 03/23/2016
Last updated 05/25/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • CO License # OTA0000500
  • WI License # 5767-27
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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