Organization
DIANA SKOGEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA LYNN SKOGEN OTR (SOLE OWNER)
(507) 525-3195
Entity
Organization
Contact information
Practice address
44070 220TH ST, DELAVAN, MN 56023-6814
(507) 525-3195
Mailing address
44070 220TH ST, DELAVAN, MN 56023-6814
(507) 525-3195
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100274
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185D8MA
BLUE CROSS BLUE SHIELD
MN
05
—
672643000
—
MN
Enumeration date
08/08/2007
Last updated
09/03/2014
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