Provider Demographics
NPI:1770679870
Name:SCHRAUTH, ROSEMARY JUNE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:JUNE
Last Name:SCHRAUTH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:ROSEMARY
Other - Middle Name:JUNE
Other - Last Name:RINZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:6544 MOHAWK RD
Mailing Address - Street 2:
Mailing Address - City:ALLENTON
Mailing Address - State:WI
Mailing Address - Zip Code:53002-9749
Mailing Address - Country:US
Mailing Address - Phone:262-629-5082
Mailing Address - Fax:
Practice Address - Street 1:5595 COUNTY ROAD Z
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-9224
Practice Address - Country:US
Practice Address - Phone:262-306-2150
Practice Address - Fax:262-306-2151
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI117026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40515300Medicaid