Individual
ANDRIA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1891 STATION PKWY NW, ANDOVER, MN 55304-3341
(763) 755-4275
Mailing address
1891 STATION PKWY NW, ANDOVER, MN 55304-3341
(763) 755-4275
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104629
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104629
MN OT LICENSE
MN
01
—
325542
NBCOT
MN
Enumeration date
01/22/2015
Last updated
01/26/2020
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