Provider Demographics
NPI:1881799732
Name:CHRISTENSEN, EMILY ANNE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANNE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANNE
Other - Last Name:BARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:25311 TRUMAN RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:WI
Mailing Address - Zip Code:53510-9707
Mailing Address - Country:US
Mailing Address - Phone:608-762-6967
Mailing Address - Fax:
Practice Address - Street 1:4135 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2628
Practice Address - Country:US
Practice Address - Phone:563-583-4003
Practice Address - Fax:563-583-4737
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01680225X00000X
WI4352-026225X00000X
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA11304OtherBCBS PROVIDER NUMBER