Provider Demographics
NPI:1205475266
Name:BARBELN, JENNA RAE (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:RAE
Last Name:BARBELN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:RAE
Other - Last Name:NEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4375 MAZULA CT NE
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-2413
Mailing Address - Country:US
Mailing Address - Phone:763-355-7905
Mailing Address - Fax:
Practice Address - Street 1:10273 YELLOW CIRCLE DR
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9144
Practice Address - Country:US
Practice Address - Phone:763-355-7905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-22
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106150225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist