Individual
AMANDA VICTORIA CLOUD GRAETZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6776 LAKE DR # 170, LINO LAKES, MN 55014-1156
(651) 784-7007
Mailing address
7306 24TH AVE N, HUGO, MN 55038-9319
(952) 239-3875
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
101140
MN
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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