Individual
ASHLEY WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
155 RADIO DRIVE, WOODBURY, MN 55125
(952) 831-8742
Mailing address
8100 NORTHLAND DR, BLOOMINGTON, MN 55431-4800
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105248
MN
Other
Enumeration date
11/03/2016
Last updated
03/17/2018
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