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MRS. TRACY RAE JOHANNECK-UTPHALL COTA NPI 1730416769


NPI Information

NPI: 1730416769
Provider Name: MRS. TRACY RAE JOHANNECK-UTPHALL, COTA
Classification: Occupational Therapy Assistant - 224Z00000X
Entity Type: Individual
Address:
3248 SHORTRIDGE DR
RACINE, WI
ZIP 53402
Phone: (414) 550-6670
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MRS. Tracy Rae Johanneck-utphall, COTA is an occupational therapy assistant in Racine, WI. The provider is an occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. MRS. Tracy Rae Johanneck-utphall, COTA NPI is 1730416769. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3248 SHORTRIDGE DR
RACINE, WI
ZIP 53402-367
Phone: (414) 550-6670

The enumeration date for this NPI number is 11/12/2009 and was last updated on 11/12/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1224Z00000XOccupational Therapy Assistant1193-27WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11193-27OTHERWISCONSINWISCONSIN LICIENSURE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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