Individual
ELIANA NICOLE STIENESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAOT, OTR/L
Contact information
Practice address
2653 COUNTY ROAD 74, SAINT CLOUD, MN 56301-2205
(320) 229-4069
(320) 229-4071
Mailing address
1404 10TH ST SE, WILLMAR, MN 56201-5421
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106404
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5757
OCCUPATIONAL THERAPY PRACTICE LICENSE
MN
Enumeration date
03/20/2020
Last updated
01/27/2022
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