Individual
LAUREN DISTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
900 W 94TH ST, BLOOMINGTON, MN 55420-4206
(952) 885-0418
Mailing address
13847 54TH AVE N, MINNEAPOLIS, MN 55446-1651
(218) 590-4915
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107372
MN
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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