Provider Demographics
NPI:1588350656
Name:CLARY, ERIN JANE (OTR)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:JANE
Last Name:CLARY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:JANE
Other - Last Name:BELLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:79 MICHAEL LN
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-3857
Mailing Address - Country:US
Mailing Address - Phone:920-970-7164
Mailing Address - Fax:
Practice Address - Street 1:500 S OAKWOOD RD
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-7944
Practice Address - Country:US
Practice Address - Phone:920-223-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8259-26225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation