Healthcare Provider Details

I. General information

NPI: 1528992997
Provider Name (Legal Business Name): REAGAN ISABELLA OBRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HIGHLAND AVE
MADISON WI
53792-0001
US

IV. Provider business mailing address

996 NORTHCREEK DR
NEENAH WI
54956-5647
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-6400
  • Fax:
Mailing address:
  • Phone: 920-277-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number920926
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: