Individual
MAUREEN H MORDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
640 JACKSON ST, MAILSTOP 11102D, SAINT PAUL, MN 55101-2502
(651) 254-5540
Mailing address
640 JACKSON ST, MAILSTOP 11102D, SAINT PAUL, MN 55101-2502
(651) 254-5540
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
28403
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28403
NCTRC
—
Enumeration date
02/22/2012
Last updated
02/22/2012
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