Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003560335 |
---|---|
Provider Name | Emily Cathryn Haugerud |
First Address | Urbandale, IA 50322-7910 |
Second Address | Mason City, IA 50401-3412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2022 |
Last Update Date | 06/02/2022 |