Individual
WENDY P GOLDBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD MED OTR CHT
Contact information
Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 243-4261
(262) 243-4261
Mailing address
2704 BIBLE CAMP RD, RHINELANDER, WI 54501
(715) 490-2954
(715) 282-7161
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
1092026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1092-26
WISCONSIN STATE LICENSE
WI
01
—
1780663013
NPI
WI
05
—
40547700
—
WI
Enumeration date
01/31/2007
Last updated
07/21/2022
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