Provider Demographics
NPI:1710366067
Name:STRUNZ, ALICIA (COTA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:STRUNZ
Suffix:
Gender:
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-2120
Mailing Address - Country:US
Mailing Address - Phone:262-202-4111
Mailing Address - Fax:
Practice Address - Street 1:68 GOOD SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WV
Practice Address - Zip Code:26807-6648
Practice Address - Country:US
Practice Address - Phone:304-358-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA11214224Z00000X
WI5474-27224Z00000X
NC17046224Z00000X
WVC2563225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant