Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 002296 | IA |
NPI | 1003211285 |
---|---|
Provider Name | Colleen Michelle Auen |
First Address | Lake View, IA 51450-7420 |
Second Address | Newell, IA 50568-5065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2014 |
Last Update Date | 29/10/2014 |