Individual
KELLY ERIN DEWEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, ORT/L
Contact information
Practice address
900 WEST 94TH STREET, BLOOMINGTON, MN 55420
(952) 885-0418
(952) 885-0173
Mailing address
900 WEST 94TH STREET, BLOOMINGTON, MN 55420
(952) 885-0418
(952) 885-0173
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103602
MN
Other
Enumeration date
08/13/2008
Last updated
06/18/2009
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