Individual
DIANA LYNN SKOGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
44070 220TH ST, DELAVAN, MN 56023-6814
(507) 525-3195
Mailing address
44070 220TH ST, DELAVAN, MN 56023-5473
(507) 525-3195
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100274
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130009100
—
MN
01
—
185D9SK
BLUE CROSS BLUE SHIELD
MN
Enumeration date
03/26/2007
Last updated
09/05/2014
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