Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner | 101041 | MN |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 101041 | MN |
NPI | 1962535948 |
---|---|
Provider Name | Ms. Jane Eileen Fjerstad |
First Address | Minneapolis, MN 55406-3023 |
Second Address | Minneapolis, MN 55407-3723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |