Individual
ELIZABETH ANN JESKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14635 PENNOCK AVE STE 300, APPLE VALLEY, MN 55124-6588
(651) 994-9644
Mailing address
14635 PENNOCK AVE STE 300, APPLE VALLEY, MN 55124-6588
(651) 994-9644
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105675
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013409879
—
MN
Enumeration date
06/06/2018
Last updated
03/23/2021
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