Provider Demographics
NPI:1700297769
Name:NEDERHOED, NOELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:NEDERHOED
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:
Other - Last Name:CASCALENDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2030 RAHN WAY
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2300
Mailing Address - Country:US
Mailing Address - Phone:952-737-6239
Mailing Address - Fax:612-728-5301
Practice Address - Street 1:2030 RAHN WAY
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2300
Practice Address - Country:US
Practice Address - Phone:952-737-6239
Practice Address - Fax:612-728-5301
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104607225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist