Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1215608229 |
---|---|
Provider Name | Karli Jahnke |
First Address | Plymouth, MN 55446-3809 |
Second Address | Golden Valley, MN 55422-4249 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2021 |
Last Update Date | 21/09/2021 |