Individual
MRS. MARALEE KAREN MOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1020 LARK ST, ALEXANDRIA, MN 56308-2269
(320) 762-1125
Mailing address
11101 CTY. RD. 16 NW, EVANSVILLE, MN 56326
(320) 524-2425
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
200826
MN
Other
Enumeration date
02/10/2016
Last updated
04/04/2017
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