Individual
KALLIE PETRICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3305 CENTRAL PARK VILLAGE DR STE 130, EAGAN, MN 55121-7707
(651) 406-8868
Mailing address
150 COBBLESTONE LANE, BURNSVILLE, MN 55044
(952) 460-4987
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104754
MN
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
02/10/2015
Last updated
07/21/2022
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