Healthcare Provider Details

I. General information

NPI: 1629909585
Provider Name (Legal Business Name): MRS. DYANNA L MAY-DUJARDIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 N JACKSON ST
ELKHORN WI
53121-1905
US

IV. Provider business mailing address

569 W CHESTNUT ST
BURLINGTON WI
53105-1017
US

V. Phone/Fax

Practice location:
  • Phone: 262-723-3160
  • Fax:
Mailing address:
  • Phone: 414-940-6981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number2884-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: