Individual
REBECCA M PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
3400 W 66TH ST, SUITE 450, EDINA, MN 55435-2111
(952) 908-2700
Mailing address
4724 OXBOROUGH CT, BROOKLYN PARK, MN 55443-3995
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101848
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263999800
—
MN
Enumeration date
08/15/2006
Last updated
07/08/2007
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