Individual
HEIDI JENSEN FENNEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0972
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0972
SOUTH DAKOTA BOARD OF MEDICAL AND OSTEOPATHIC EXAMINERS
SD
Enumeration date
10/04/2021
Last updated
10/04/2021
Update your record
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