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Individual

MRS. LYNNETTE RENEE OPHAUG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
2602 FIFIELD RD, PELLA, IA 50219-7925
(641) 458-6411
Mailing address
225 PRAIRIE VIEW DR APT 11215, WEST DES MOINES, IA 50266-7140
(218) 791-7521

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
103462
MN
225X00000X
Occupational Therapist
Primary
110486
IA
225X00000X
Occupational Therapist
933
ND

Other

Enumeration date
06/01/2007
Last updated
12/14/2021
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