Individual
KATHRYN BOUTIETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
231 FOX ST, PERHAM, MN 56573-2337
(218) 346-2322
Mailing address
38809 S MARION DR, RICHVILLE, MN 56576-9606
(218) 457-2878
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106303
MN
Other
Enumeration date
09/22/2020
Last updated
11/22/2023
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