Individual
JESSICA KOPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12450 CLOUD DR NE, BLAINE, MN 55449-6274
(763) 777-7117
Mailing address
12450 CLOUD DR NE, BLAINE, MN 55449-6274
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103282
MN
Other
Enumeration date
11/10/2006
Last updated
04/01/2020
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