Healthcare Provider Details

I. General information

NPI: 1225948094
Provider Name (Legal Business Name): EMMA GOODING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16185 BURLEIGH PL
BROOKFIELD WI
53005-2899
US

IV. Provider business mailing address

3555 N CALHOUN RD
BROOKFIELD WI
53005-1700
US

V. Phone/Fax

Practice location:
  • Phone: 262-781-5280
  • Fax:
Mailing address:
  • Phone: 262-781-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6437-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: