Individual
AMANDA JO MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2319 7TH ST W, SAINT PAUL, MN 55116-2813
(651) 698-0793
(651) 698-0378
Mailing address
3649 QUAIL AVE N, ROBBINSDALE, MN 55422-2060
(763) 614-8064
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202619
MN
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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