Individual
TANYA C USSERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
3401 E MEDICINE LAKE BLVD, PLYMOUTH, MN 55441-2307
(763) 559-3123
Mailing address
813 QUEENS LN, ANOKA, MN 55303-2840
(763) 898-6228
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201450
MN
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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