Individual
ELLEN PLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3931 LOUISIANA AVE S, ST LOUIS PARK, MN 55426-5000
(952) 993-3230
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100915
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
532G6PL
BCBS
MN
05
—
616055700
—
MN
01
—
6406149
MEDICA
MN
01
—
HP22435
HEALTH PARTNERS
MN
Enumeration date
09/29/2006
Last updated
03/11/2021
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