Provider Demographics
NPI:1033341557
Name:TROYER, RENAE JOY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:RENAE
Middle Name:JOY
Last Name:TROYER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 GOLD DR. S.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6416
Mailing Address - Country:US
Mailing Address - Phone:701-451-9417
Mailing Address - Fax:701-298-0066
Practice Address - Street 1:1711 GOLD DR. S.
Practice Address - Street 2:SUITE 120
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6416
Practice Address - Country:US
Practice Address - Phone:701-451-9417
Practice Address - Fax:701-298-0066
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND197225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist