| Doctor Name: | KATE ONYENEHO |
| NPI Number: | 1417327347 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 365664 |
| Business Practice Address: | 6000 Bass Lake Rd Ste 206 Crystal, MN - 554292766 |
| Business Phone Number: | 9523562953 |
| Business Fax Number: | |
| Mailing Address: | 6000 Bass Lake Rd Ste 206, CRYSTAL |
| State: | MN |
| Postal Code: | 554292766 |
| Phone Number: | 9523562953 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2015 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | 365664 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |