Individual
AMANDA F BERANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
300 S BRUCE ST, MARSHALL, MN 56258-1934
(507) 537-9172
Mailing address
300 S BRUCE ST, MARSHALL, MN 56258-1934
(507) 537-9172
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0724
SD
225X00000X
Occupational Therapist
Primary
103494
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790942217
—
MN
Enumeration date
05/21/2008
Last updated
01/27/2020
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