Kristin Amie Bruley, M.O.T.R./L

Individual provider Active NPI Occupational Therapist · Crookston, MN

NPI 1780930917 · NPPES record last updated Jul 25, 2012

Key facts

NPI
1780930917
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
103085 (MN)
Practice address
323 S Minnesota St
Crookston, MN 56716-1601
Phone
(218) 281-9463
Fax
(218) 281-9336
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 103085 MN Yes
Occupational Therapist 225X00000X 994 ND

Addresses

Primary practice location

323 S Minnesota St
Crookston, MN 56716-1601

Mailing address

323 S Minnesota St
Crookston, MN 56716-1601

Other providers in Crookston, MN

All providers in Crookston, MN · Occupational Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.