Provider Demographics
NPI:1669913083
Name:SCHULZ, SONDRA LYNN (COTA)
Entity type:Individual
Prefix:MRS
First Name:SONDRA
Middle Name:LYNN
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MS
Other - First Name:SONDRA
Other - Middle Name:LYNN
Other - Last Name:ROSENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:4524 OLIVE STR.
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-3938
Mailing Address - Country:US
Mailing Address - Phone:262-498-4356
Mailing Address - Fax:
Practice Address - Street 1:7545 N. PORT WASHINGTON RD.
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217
Practice Address - Country:US
Practice Address - Phone:414-797-2254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5342-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant