MEDICARE: MARIAH NOEL STENEN

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
1	225200000X	Physical Therapy Assistant	A2932	MN

General Provider Information

NPI Number	:	1235905779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAH NOEL STENEN

Provider Business Mailing Address
First Line	:	369 139TH LN NW
Second Line	:
City	:	ANDOVER
State	:	MN
Zip	:	55304-4165
Country	:	US
Telephone Number	:	763-233-9668
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 HIGHWOOD DR
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-1079
Country	:	US
Telephone Number	:	952-831-7500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2023
Last Update Date	:	11/27/2023

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Directions to “ MARIAH NOEL STENEN ” Practice Location

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