Individual
NOU LOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-8000
Mailing address
2055 ORANGE AVE E, SAINT PAUL, MN 55119-3262
(651) 468-1720
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105111
MN
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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