Individual
LANDRY ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
525 W RIVER WOODS PKWY STE 230, GLENDALE, WI 53212-1010
(414) 453-7418
(414) 967-1151
Mailing address
525 W RIVER WOODS PKWY STE 230, GLENDALE, WI 53212-1010
(414) 453-7418
(414) 967-1151
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
225X00000X
Occupational Therapist
9005-26
WI
225XH1200X
Hand Occupational Therapist
Primary
9005-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9005-26
LICENSE
WI
Enumeration date
11/14/2022
Last updated
03/10/2026
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