| NPI | 1790900520 |
|---|---|
| Former Name | ANGELA JEAN FENEIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: MN 103170) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 103170) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2009-12-17 |