# MIDWEST REHABILITATION ASSOCIATES, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598877375
- **Authorized official:** MRS. MARY WRIGHT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (414) 476-8183

## Contact information

- **Practice address:** 2525 N MAYFAIR RD, SUITE 200, WAUWATOSA, WI 53226-1403
- **Practice address phone:** (414) 476-8183
- **Practice address fax:** (414) 476-8465
- **Mailing address:** 2525 N MAYFAIR RD, SUITE 200, WAUWATOSA, WI 53226-1403
- **Mailing address phone:** (414) 476-8183
- **Mailing address fax:** (414) 476-8465

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TH0100X | Health Service Psychologist | — | NULL | — |
| 103TH0100X | Health Service Psychologist | — | — | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | NULL | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2084N0600X | Clinical Neurophysiology Physician | — | NULL | — |
| 2084N0600X | Clinical Neurophysiology Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 246ZE0600X | Electroneurodiagnostic Specialist/Technologist | — | NULL | — |
| 246ZE0600X | Electroneurodiagnostic Specialist/Technologist | — | — | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 12/17/2012