Individual
MICHELLE MARIE FERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
80 MINNESOTA AVE, THERAPY CONNECTIONS FOR KIDS, LITTLE CANADA, MN 55117-1781
(651) 206-3697
Mailing address
1951 FREMONT AVE E, SAINT PAUL, MN 55119-4013
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5301
WI
225100000X
Physical Therapist
Primary
5402
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41810700
—
WI
01
—
77G76FE
BCBS
MN
Enumeration date
09/26/2006
Last updated
07/09/2007
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