Individual
CARLY ANN DEROUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L, CLT
Contact information
Practice address
612 S SIBLEY AVE, LITCHFIELD, MN 55355-3340
(206) 934-5283
Mailing address
2358 47TH AVE NE, WILLMAR, MN 56201-9422
(320) 444-6816
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106676
MN
225X00000X
Occupational Therapist
1905
ND
Other
Enumeration date
11/03/2022
Last updated
11/22/2023
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