Organization
KEY CORPORATION
Active
Other names
Professional Rehabilitation Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESA M BOWLIN (ADMINISTRATOR)
(651) 784-7828
Entity
Organization
Contact information
Practice address
1394 JACKSON ST STE 201, SAINT PAUL, MN 55117-4630
(651) 603-8774
(651) 603-9009
Mailing address
1394 JACKSON ST STE 201, SAINT PAUL, MN 55117-4630
(651) 603-8774
(651) 603-9009
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103288
UCARE
MN
01
—
6G530PR
BLUE CROSS BLUE SHIELD
MN
05
—
756104100
—
MN
05
—
876555300
—
MN
Enumeration date
12/11/2006
Last updated
03/13/2021
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