Individual
THERESA OMOLOLA HEINEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8320 CITY CENTRE DR, SUITE G., WOODBURY, MN 55125-3382
(651) 738-9888
(651) 738-9889
Mailing address
8320 CITY CENTRE DR, SUITE G., WOODBURY, MN 55125-3382
(651) 738-9888
(651) 738-9889
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
103873
MN
Other
Enumeration date
04/19/2010
Last updated
09/27/2010
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