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Individual

LEANN WALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, OTR/L

Contact information

Practice address
464 2ND ST STE 106, EXCELSIOR, MN 55331-2108
(952) 401-4242
Mailing address
464 2ND ST STE 106, EXCELSIOR, MN 55331-2108
(952) 401-4242

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
104513
MN
225XP0200X
Pediatric Occupational Therapist
Primary
104513
MN

Other

Enumeration date
11/12/2013
Last updated
11/12/2013
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