Healthcare Provider Details

I. General information

NPI: 1538926647
Provider Name (Legal Business Name): KATHERINE GOEBEL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N OAK AVE
MARSHFIELD WI
54449-5703
US

IV. Provider business mailing address

4461 S RIVER RIDGE BLVD
GREENFIELD WI
53228-2471
US

V. Phone/Fax

Practice location:
  • Phone: 715-387-5511
  • Fax:
Mailing address:
  • Phone: 414-350-7911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number8476-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: