Individual
KATHRYN ANN VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
135 GERANIUM AVE E, SAINT PAUL, MN 55117-5007
(651) 272-4501
(651) 488-7408
Mailing address
200 LEWIS AVE S, SUITE 210, WATERTOWN, MN 55388-4545
(952) 955-2242
(952) 955-2010
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
104200
MN
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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