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Individual

ALLYSON CHANTELLE BOURQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
1304 ARMSTRONG RD NW, ALEXANDRIA, MN 56308-5363
(925) 768-3939

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107226
MN

Other

Enumeration date
08/22/2023
Last updated
08/22/2023
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