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NPI Code Detail

MEDICARE: JENNA JEAN SEMRAU OTR/L

MEDICARE: JENNA JEAN SEMRAU OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist106261MN

General Provider Information

NPI Number : 1740807635
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA JEAN SEMRAU OTR/L
Provider Business Mailing Address
First Line : 10635 RAVEN LOOP
Second Line :
City : FOLEY
State : MN
Zip : 56329-9008
Country : US
Telephone Number : 320-291-3451
Fax Number :
Provider Business Practice Location Address
First Line : 2653 COUNTY ROAD 74
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-2205
Country : US
Telephone Number : 320-291-3451
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2020
Last Update Date : 06/26/2020

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Directions to “ JENNA JEAN SEMRAU OTR/L” Practice Location

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