Individual
LIVINUS DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1822 IDAHO AVE E, SAINT PAUL, MN 55119-4209
(651) 239-3873
Mailing address
1822 IDAHO AVE E, SAINT PAUL, MN 55119-4209
(651) 239-3873
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202094
MN
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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