Individual
STACY INGVALSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1801 AMERICAN BLVD E, UNIT 1, BLOOMINGTON, MN 55425-1232
(952) 767-2276
Mailing address
1801 AMERICAN BLVD E, UNIT 1, BLOOMINGTON, MN 55425-1232
(952) 767-2276
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
281119
OR
Other
Enumeration date
04/16/2013
Last updated
09/28/2016
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