Individual
MICHELLE LOUISE KOYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. OTR/L
Contact information
Practice address
1800 2ND ST NE, MINNEAPOLIS, MN 55418-4306
(612) 789-1236
(612) 706-5555
Mailing address
1800 2ND ST NE, MINNEAPOLIS, MN 55418-4306
(612) 789-1236
(612) 706-5555
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104344
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104344
STATE LICENSE
MN
Enumeration date
01/17/2013
Last updated
01/17/2013
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