Individual
EMILY A BOUGHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
15590 90TH ST NE, OTSEGO, MN 55330-9452
(763) 755-4275
(763) 755-4261
Mailing address
1891 STATION PARKWAY NW, ANDOVER, MN 55304-4259
(763) 755-4275
(763) 755-4261
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104970
MN
225XP0200X
Pediatric Occupational Therapist
104970
MN
Other
Enumeration date
09/21/2015
Last updated
10/25/2017
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