Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Wagner, COTA

Individual provider Occupational Therapy Assistant · NPI 1033842075

Mary Wagner, COTA is an Occupational Therapy Assistant in Kenosha, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2022
What do these letters mean?
COTA — Certified Occupational Therapy Assistant
Delivers treatment under an occupational therapist's direction.

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Practice location Address checks out

3415 Sheridan Rd
Kenosha, WI 53140-1924
Phone: (262) 657-6175
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 5738-27 (WI)

Record details

NPI number1033842075
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA
Sole proprietorYes
NPI enumeratedJuly 7, 2022
Last updated in NPPESJuly 7, 2022
Certification dateJune 27, 2022

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