Individual
MARY BETH WULF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/CHT
Contact information
Practice address
8100 NORTHLAND DR, BLOOMINGTON, MN 55431-4800
(952) 831-8742
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54931819
—
CO
Enumeration date
03/08/2006
Last updated
04/09/2018
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