Provider Demographics
NPI:1285900571
Name:KNIGGE, MALEAH KAY (OTR)
Entity type:Individual
Prefix:
First Name:MALEAH
Middle Name:KAY
Last Name:KNIGGE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 ROOSEVELT RD
Mailing Address - Street 2:STE 200A
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-9737
Mailing Address - Country:US
Mailing Address - Phone:320-420-4080
Mailing Address - Fax:320-229-4071
Practice Address - Street 1:3315 ROOSEVELT RD
Practice Address - Street 2:STE 200A
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-9737
Practice Address - Country:US
Practice Address - Phone:320-420-4080
Practice Address - Fax:320-229-4071
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104220225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist