Individual
ANGELA TILSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4415 W 36 1/2 ST, SAINT LOUIS PARK, MN 55416-4854
(952) 927-9717
Mailing address
2218 SPRUCE PL, WHITE BEAR LAKE, MN 55110-4734
(651) 210-3507
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
202112
MN
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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