Healthcare Provider Details

I. General information

NPI: 1770557191
Provider Name (Legal Business Name): KRISTIN MICHELLE SCHMIDT SOLBERG OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3207 220TH TRL
AMANA IA
52203-8206
US

IV. Provider business mailing address

3037 210TH ST
HOMESTEAD IA
52236-8524
US

V. Phone/Fax

Practice location:
  • Phone: 319-622-3131
  • Fax:
Mailing address:
  • Phone: 319-662-4153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number01382
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: