Individual
MARJORIE MARIE KERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3211 COLFAX AVE S, APT 3, MINNEAPOLIS, MN 55408-3509
(414) 587-1256
Mailing address
3211 COLFAX AVE S, APT 3, MINNEAPOLIS, MN 55408-3509
(414) 587-1256
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104776
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104776
MINNESOTA OT LICENSE CREDENTIAL
MN
Enumeration date
10/28/2014
Last updated
10/28/2014
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