Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 106224 | MN |
NPI | 1053931428 |
---|---|
Provider Name | Amber J Kerfeld |
First Address | Fargo, ND 58103-4940 |
Second Address | Duluth, MN 55805-1913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2020 |
Last Update Date | 25/04/2020 |