Healthcare Provider Details

I. General information

NPI: 1356457097
Provider Name (Legal Business Name): SANDRA K BRAUN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA K BAUER

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223825 COUNTY ROAD O
MARATHON WI
54448-7591
US

IV. Provider business mailing address

223825 COUNTY ROAD O
MARATHON WI
54448-7591
US

V. Phone/Fax

Practice location:
  • Phone: 715-551-2100
  • Fax:
Mailing address:
  • Phone: 715-551-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1554
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: