Individual
JENNA MARIE MATTESON LAABS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAOT, OTR/L
Contact information
Practice address
3111 124TH AVE NW STE 123, COON RAPIDS, MN 55433-4573
(763) 236-7337
Mailing address
399 ELM ST, LINO LAKES, MN 55014-1269
(763) 792-5434
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104672
MN
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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