Provider Demographics
NPI:1841460839
Name:SCHMIDT, WENDY (OTR/L CHT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:OTR/L CHT
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:GREGOVICH/BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1155 N MAYFAIR RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3462
Mailing Address - Country:US
Mailing Address - Phone:414-955-4263
Mailing Address - Fax:414-955-6286
Practice Address - Street 1:1155 N MAYFAIR RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3462
Practice Address - Country:US
Practice Address - Phone:414-955-4263
Practice Address - Fax:414-955-6286
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4380-026225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073938OtherNBCOT
WI4380-26OtherWISCONSIN OT
201005096OtherCERTIFIED HAND THERAPIST
WI40903600Medicaid