Individual
CHANDLER ELISE DOMIAN OMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3123
Mailing address
1374 JULIET AVE, SAINT PAUL, MN 55105-2501
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105801
MN
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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