Individual
JADE RENAE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6200 XERXES AVE S, EDINA, MN 55423-1033
(952) 925-8500
Mailing address
10400 BREN RD E APT 537, HOPKINS, MN 55343-0099
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202847
MN
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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