Healthcare Provider Details

I. General information

NPI: 1356275671
Provider Name (Legal Business Name): MICHELLE MILBAUER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 W VLIET ST
MILWAUKEE WI
53208-2698
US

IV. Provider business mailing address

3269 E LUNHAM AVE
CUDAHY WI
53110-1028
US

V. Phone/Fax

Practice location:
  • Phone: 414-475-8393
  • Fax:
Mailing address:
  • Phone: 414-475-8393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number6307-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: