Emily Gough Henry, OTR/L
Individual provider Active NPI Occupational Therapist · Royal Oak, MI
NPI 1124694682 · NPPES record last updated May 21, 2025
Key facts
- NPI
- 1124694682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 6987-26 (WI)
- Practice address
- 2512 Rochester Rd
Royal Oak, MI 48073-3635 - Phone
- (248) 733-4325
- Fax
- (248) 268-7979
- NPI assigned
- Jun 3, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Back to You Rehab PLLC
Practice addresses (Care Compare)
2512 Rochester Rd
Royal Oak, MI 48073-3635
Phone (248) 733-4325
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241018000485 | MI | Practitioner - Occupational Therapist in Private Practice | 1658803374 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6987-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back to You Rehab PLLC | Occupational Therapist | Current |
Accepting new patients |
Locations
39933 Ford Rd
Canton, MI 48187
Phone (248) 733-4325
21316 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (248) 733-4325
2512 Rochester Rd
Royal Oak, MI 48073
Phone (248) 733-4325
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 6987-26 | WI | Yes |
Addresses
Primary practice location
2512 Rochester Rd
Royal Oak, MI 48073-3635
Mailing address
1008 Byrd Ave
Neenah, WI 54956-3915
Other practice location 1
E7475 Rawhide Rd
New London, WI 54961-9025
Phone (920) 538-1424
Other names
- Ms. Emily Katherine Gough
Other providers in Royal Oak, MI
- Samantha Lyn Hennells
- Marisa Henriksen
- Henry Ford Health System
- Henry Ford Health System
- Henry M Traurig, PC
- Takato Henry
- Kjerstin Hensley
- Melissa Ann Hentschel
- Lauren Hepola
- Randy Hermann
All providers in Royal Oak, MI · Occupational Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.