Individual
MISS ANDREA MARIE CONVERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
300 S BRUCE ST, MARSHALL, MN 56258-1934
(507) 537-9172
Mailing address
300 S BRUCE ST, MARSHALL, MN 56258-1934
(507) 537-9172
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202189
MN
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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