Healthcare Provider Details

I. General information

NPI: 1982538781
Provider Name (Legal Business Name): VICKI LYNN UMHOEFER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N104W13840 DONGES BAY RD
GERMANTOWN WI
53022-4430
US

IV. Provider business mailing address

4955 HWY 144
HARTFORD WI
53027-9557
US

V. Phone/Fax

Practice location:
  • Phone: 262-253-3917
  • Fax:
Mailing address:
  • Phone: 262-573-1549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number4051001373
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: