Individual
ANN ECKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5842 HOBE LN, WHITE BEAR LAKE, MN 55110
(651) 383-1197
Mailing address
5842 HOBE LN, WHITE BEAR LAKE, MN 55110-6477
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104835
MN
225X00000X
Occupational Therapist
337739
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104835
MINNESOTA DEPARTMENT OF HEALTH
MN
01
—
337739
NBCOT
—
Enumeration date
09/14/2015
Last updated
05/24/2018
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