Individual
ALISON ENUMA IKEOGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(651) 254-3200
(651) 254-7710
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105521
MN
Other
Enumeration date
10/02/2017
Last updated
11/18/2021
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