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Individual

JERI ANN MULLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2400 W 64TH ST, MINNEAPOLIS, MN 55423-1001
(612) 798-8341
(612) 728-5301
Mailing address
952 EDMUND AVE, SAINT PAUL, MN 55104-2622

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103401
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103401
MINNESOTA DEPARTMENT OF HEALTH
MN
Enumeration date
03/30/2007
Last updated
06/16/2018
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