Individual
MRS. STACEY MARIE OHUMUKINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5480 NATHAN LN N, STE 140, PLYMOUTH, MN 55442-1997
(612) 597-2975
Mailing address
513 2ND AVE NW, BUFFALO, MN 55313-1126
(612) 597-2975
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104854
MN
Other
Enumeration date
03/16/2015
Last updated
03/19/2015
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