Provider Demographics
NPI:1013379320
Name:FUOSS, MCKINSIE JEAN (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:MCKINSIE
Middle Name:JEAN
Last Name:FUOSS
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:MCKINSIE
Other - Middle Name:JEAN
Other - Last Name:SIMONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:WINNER
Mailing Address - State:SD
Mailing Address - Zip Code:57580-0435
Mailing Address - Country:US
Mailing Address - Phone:605-842-7188
Mailing Address - Fax:605-842-7189
Practice Address - Street 1:825 E. 8TH ST.
Practice Address - Street 2:SUITE 204
Practice Address - City:WINNER
Practice Address - State:SD
Practice Address - Zip Code:57580-2633
Practice Address - Country:US
Practice Address - Phone:605-842-7188
Practice Address - Fax:605-842-7189
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0995225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist