Provider Demographics
NPI:1215608229
Name:JAHNKE, KARLI (OT)
Entity type:Individual
Prefix:
First Name:KARLI
Middle Name:
Last Name:JAHNKE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KARLI
Other - Middle Name:
Other - Last Name:MORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5357 DALLAS LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-3809
Mailing Address - Country:US
Mailing Address - Phone:701-220-1908
Mailing Address - Fax:
Practice Address - Street 1:3915 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4249
Practice Address - Country:US
Practice Address - Phone:612-775-2499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation