Individual
JOLENE AUDREY MCMAHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-2060
Mailing address
26245 GOLDEN AVE, WYOMING, MN 55092-8026
(651) 890-7990
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104114
MN
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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