Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 103547 | MN |
NPI | 1003093006 |
---|---|
Provider Name | Amy L Krekelberg |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2008 |
Last Update Date | 11/08/2020 |