Provider Demographics
NPI:1194493106
Name:DUKLETH, ABBY E (OTR/L)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:E
Last Name:DUKLETH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:WENDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:BIG STONE CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57216-8237
Mailing Address - Country:US
Mailing Address - Phone:605-541-1140
Mailing Address - Fax:605-541-0109
Practice Address - Street 1:700 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MINNEOTA
Practice Address - State:MN
Practice Address - Zip Code:56264-9237
Practice Address - Country:US
Practice Address - Phone:605-541-1140
Practice Address - Fax:605-541-0109
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106613225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist