Individual
MS. LISA R WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA OTR/L
Contact information
Practice address
15646 76TH PL N, MAPLE GROVE, MN 55311-2677
(763) 229-9891
Mailing address
15646 76TH PL N, MAPLE GROVE, MN 55311-2677
(763) 229-9891
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
101179
MN
Other
Enumeration date
06/05/2008
Last updated
02/08/2012
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