Individual
CARISSA R HOLMSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, OTR/L
Contact information
Practice address
559 CAPITOL BLVD, SAINT PAUL, MN 55103-2101
(651) 232-2128
Mailing address
1846 OXFORD ST N, ROSEVILLE, MN 55113-6523
(651) 402-9179
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103724
MN
Other
Enumeration date
04/16/2010
Last updated
04/16/2010
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