Healthcare Provider Details

I. General information

NPI: 1053225573
Provider Name (Legal Business Name): EMMA VOGE MSOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 N 14TH ST STE 324
SUPERIOR WI
54880-1778
US

IV. Provider business mailing address

2481 HIDDEN PINES DR
CARLTON MN
55718-8265
US

V. Phone/Fax

Practice location:
  • Phone: 715-395-7347
  • Fax:
Mailing address:
  • Phone: 715-554-7192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number107396
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: