Individual
JANICE FAYE GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5320 W 23RD ST, ST LOUIS PARK, MN 55416-1663
(952) 486-0293
Mailing address
11821 RED FOX DR, MAPLE GROVE, MN 55369-6339
(612) 760-6746
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101776
MN
Other
Enumeration date
04/09/2009
Last updated
05/20/2020
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