Individual
CASSIDY ERICKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1670 LEGACY PKWY E, MAPLEWOOD, MN 55109-5469
(952) 697-0627
(479) 201-2084
Mailing address
1670 LEGACY PKWY E, MAPLEWOOD, MN 55109-5469
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202015
MN
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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