Individual
SHELBY LANAE GJELHAUG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5947 138TH ST NE, PRIOR LAKE, MN 55372-4486
(612) 849-1505
Mailing address
5947 138TH ST NE, PRIOR LAKE, MN 55372-4486
(612) 849-1505
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202222
MN
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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