Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 202052 | MN |
NPI | 1013586122 |
---|---|
Provider Name | Natalie Briann Marquart |
First Address | Fergus Falls, MN 56537-3723 |
Second Address | Fergus Falls, MN 56537-3723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2021 |
Last Update Date | 22/06/2021 |