Individual
LISA BRAITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
16137 80TH AVE, MILACA, MN 56353-3565
(763) 689-5385
Mailing address
16137 80TH AVE, MILACA, MN 56353-3565
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102855
MN
Other
Enumeration date
04/13/2010
Last updated
04/13/2010
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