Individual
AYALA NOGUEIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4638 VICTOR PATH STE 100, HUGO, MN 55038-4732
(651) 407-3777
Mailing address
4800 CENTERVILLE RD APT 306, SAINT PAUL, MN 55127-2215
(404) 977-0258
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107202
MN
225XP0200X
Pediatric Occupational Therapist
107202
MN
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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