Individual
MRS. MATTIE LEE ANHELUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-5488
(651) 241-7177
Mailing address
ABBOTT NORTHWESTERN HOSPITAL, 800 E 28TH STREET, MINNEAPOLIS, MN 55407-3799
(612) 562-2945
(126) 863-8942
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103472
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103472
OT PRACTICTIONER LICENSE
MN
Enumeration date
04/02/2008
Last updated
01/03/2022
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