Provider Demographics
NPI:1588066195
Name:BUTLER, EMILY (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 EVERGREEN CIR
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-3359
Mailing Address - Country:US
Mailing Address - Phone:402-239-0440
Mailing Address - Fax:
Practice Address - Street 1:2600 EVERGREEN CIR
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-3359
Practice Address - Country:US
Practice Address - Phone:402-239-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR305612225X00000X
CA13429225X00000X
WAOT60338947225X00000X
IA002315225X00000X
MN104525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist