Active NPI
Maralee Karen Moen, COTA/L
- Occupational Therapy Assistant
- Alexandria, MN
National Provider Identifier
1629436225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 200826
- Practice address
- 1020 Lark St
Alexandria, MN 56308-2269 - Phone
- (320) 762-1125
- NPI assigned
- Feb 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 200826 | MN | Primary |
Addresses
Primary practice location
1020 Lark St
Alexandria, MN 56308-2269
Mailing address
11101 Cty. Rd. 16 NW
Evansville, MN 56326
Phone (320) 524-2425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200826 | MN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491264000000",
"number": "1629436225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11101 CTY. RD. 16 NW",
"city": "EVANSVILLE",
"state": "MN",
"postal_code": "56326",
"telephone_number": "320-524-2425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 LARK ST",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563082269",
"telephone_number": "320-762-1125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOEN",
"first_name": "MARALEE",
"middle_name": "KAREN",
"name_prefix": "Mrs.",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-10",
"last_updated": "2017-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MN",
"license": "200826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.