Healthcare Provider Details

I. General information

NPI: 1669974044
Provider Name (Legal Business Name): EMILY HERBRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY GUTJAHR

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N 92ND ST
MILWAUKEE WI
53226-3533
US

IV. Provider business mailing address

1203 GRANT ST
WAUKESHA WI
53186-6309
US

V. Phone/Fax

Practice location:
  • Phone: 272-782-9015
  • Fax: 262-782-9013
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: