Healthcare Provider Details

I. General information

NPI: 1356271548
Provider Name (Legal Business Name): EMILY GREZENSKI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17800 US HIGHWAY 18
APPLE VALLEY CA
92307-1221
US

IV. Provider business mailing address

4708 NICOLET AVE
STEVENS POINT WI
54481-5679
US

V. Phone/Fax

Practice location:
  • Phone: 760-552-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number28790
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number108124
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: