Individual
LEAH VIZENOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
(651) 439-1234
Mailing address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100442
MN
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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