Individual
JENNY TESSA DERASMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(763) 588-0811
Mailing address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(763) 588-0811
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
200985
MN
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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