Individual
KELLEY ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1929 2ND ST NE, MINNEAPOLIS, MN 55418-4367
(763) 689-5385
Mailing address
15543 FLIGHT WAY, APPLE VALLEY, MN 55124-6019
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102363
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005F5ER
BLUE CROSS BLUE SHIELD
MN
01
—
6402181
MEDICA
MN
01
—
HP45744
HEALTH PARTNERS
MN
Enumeration date
09/26/2006
Last updated
07/09/2007
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