Provider Demographics
NPI:1306046198
Name:EISCH, ERIN F (OT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:F
Last Name:EISCH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:F
Other - Last Name:EISCH-HUGUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 827
Mailing Address - Street 2:
Mailing Address - City:ARBOR VITAE
Mailing Address - State:WI
Mailing Address - Zip Code:54568-0827
Mailing Address - Country:US
Mailing Address - Phone:715-356-9729
Mailing Address - Fax:
Practice Address - Street 1:1256 BRANDY LAKE RD
Practice Address - Street 2:
Practice Address - City:ARBOR VITAE
Practice Address - State:WI
Practice Address - Zip Code:54568-0827
Practice Address - Country:US
Practice Address - Phone:715-356-9729
Practice Address - Fax:715-358-5209
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4387-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist