Individual
SARAH GRACE KIRVIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082
(651) 439-1234
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 439-1234
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103843
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225XP0019X
—
MN
Enumeration date
08/16/2018
Last updated
08/23/2018
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