Individual
MS. KATY LYNN PRENEVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8184
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8184
PT LICENSE #
MN
Enumeration date
12/10/2008
Last updated
12/10/2008
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