Individual
MARIAH KATHLEEN PICKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12910 12TH ST N, LAKE ELMO, MN 55042-8602
(651) 242-3453
Mailing address
12910 12TH ST N, LAKE ELMO, MN 55042-8602
(651) 242-3453
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
449927
MN
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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