Individual
FUAB HER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(763) 236-6000
Mailing address
11633 MARYLAND LN, CHAMPLIN, MN 55316-2887
(612) 417-9541
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
02/17/2017
Last updated
02/17/2017
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