Emily E Desjarlais

Individual provider Active NPI Occupational Therapy Assistant · Portage, WI

NPI 1053989434 · NPPES record last updated Jun 14, 2021

Key facts

NPI
1053989434
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Practice address
2815 New Pinery Rd
Portage, WI 53901-9257
Phone
(608) 742-4131
NPI assigned
Jun 14, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X Yes

Addresses

Primary practice location

2815 New Pinery Rd
Portage, WI 53901-9257

Mailing address

429 Ridgeway Dr
Rio, WI 53960-8042
Phone (608) 617-4959

Other identifiers

IdentifierTypeStateIssuer
1124083894OtherWIEMPLOYER

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address emily.desjarlais@aspirus.org

Other providers in Portage, WI

All providers in Portage, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.