Organization
INNOVATIVE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO DANIELSON MAOTR/L (OWNER/OCCUPATIONAL THERAPIST)
(612) 597-2975
Entity
Organization
Contact information
Practice address
5480 NATHAN LN N STE 140, PLYMOUTH, MN 55442-1995
(612) 597-2975
Mailing address
1696 7TH ST NW, BUFFALO, MN 55313-5050
(612) 597-2975
(763) 682-1668
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128152600
—
MN
01
—
183942
U-CARE
MN
Enumeration date
07/10/2006
Last updated
12/19/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up