Healthcare Provider Details

I. General information

NPI: 1871405738
Provider Name (Legal Business Name): STEPHANIE FARNHAM OCCUPATIONAL THERAPI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E SCHOOL ST
SHARON WI
53585-9641
US

IV. Provider business mailing address

85 OAKWOOD ST
WILLIAMS BAY WI
53191-9705
US

V. Phone/Fax

Practice location:
  • Phone: 262-736-4477
  • Fax:
Mailing address:
  • Phone: 262-736-4477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3077-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: