Provider Demographics
NPI:1265199285
Name:ORTH, EMILY (OTR)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ORTH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 FALLS PARC DR APT 7
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53085-3418
Mailing Address - Country:US
Mailing Address - Phone:920-627-7751
Mailing Address - Fax:
Practice Address - Street 1:517 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-3735
Practice Address - Country:US
Practice Address - Phone:920-921-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist