Provider Demographics
NPI:1356457097
Name:BRAUN, SANDRA K (OT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:BRAUN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:K
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-3948
Mailing Address - Country:US
Mailing Address - Phone:715-907-0900
Mailing Address - Fax:715-803-6977
Practice Address - Street 1:3901 STEWART AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-3948
Practice Address - Country:US
Practice Address - Phone:715-841-0002
Practice Address - Fax:715-841-0003
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1554225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100161305Medicaid
WI100137090Medicaid