| NPI | 1669729752 |
|---|---|
| Former Name | KELLY ANN MOENING |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 101002) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 612-026) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2012-08-08 |