Individual
ANN MARGARET LISH-MITCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
7012 30TH AVE N, CRYSTAL, MN 55427-2942
(763) 546-7221
Mailing address
7012 30TH AVE N, CRYSTAL, MN 55427-2942
(763) 546-7221
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100736
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100736
OT STATE LIC.
MN
Enumeration date
02/20/2007
Last updated
07/08/2007
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