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NPI Code Detail

MEDICARE: KATHERINE GOEBEL OTR/L

MEDICARE:   KATHERINE  GOEBEL  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist8476-26WI

General Provider Information

NPI Number : 1538926647
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE GOEBEL OTR/L
Provider Business Mailing Address
First Line : 4461 S RIVER RIDGE BLVD
Second Line :
City : GREENFIELD
State : WI
Zip : 53228-2471
Country : US
Telephone Number : 414-350-7911
Fax Number :
Provider Business Practice Location Address
First Line : 3200 S 103RD ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-4104
Country : US
Telephone Number : 414-441-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2024
Last Update Date : 03/05/2024

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Directions to “ KATHERINE GOEBEL OTR/L” Practice Location

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