Individual
STACIE KAYE WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3815 W BROADWAY AVE, ROBBINSDALE, MN 55422-2207
(612) 332-4262
Mailing address
6705 401ST ST, NORTH BRANCH, MN 55056-3312
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102230
MN
Other
Enumeration date
06/03/2013
Last updated
06/03/2013
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