Provider Demographics
NPI:1083841001
Name:KADLEC, JANE CARLEEN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:CARLEEN
Last Name:KADLEC
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 1:5243 HUMBOLDT AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55430-3428
Mailing Address - Country:US
Mailing Address - Phone:612-588-1349
Mailing Address - Fax:
Practice Address - Street 1:5243 HUMBOLDT AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55430-3428
Practice Address - Country:US
Practice Address - Phone:612-588-1349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100776225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist