Individual
LINDA JANE SPEIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11325 LANEWOOD CIR, EDEN PRAIRIE, MN 55344-4071
(952) 941-7153
Mailing address
11325 LANEWOOD CIR., EDEN PRAIRIE, MN 55344
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101601
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101601
STATE OF MN LICENSE
MN
01
—
AA322172
NATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY
—
Enumeration date
10/10/2008
Last updated
10/10/2008
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