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Individual

ALEXIS KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1879 FERONIA AVE, SAINT PAUL, MN 55104-3549
(651) 333-0785
Mailing address
7408 EDGEWOOD AVE N, BROOKLYN PARK, MN 55428-1440
(651) 333-0785

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
002272
IA
225X00000X
Occupational Therapist
Primary
104158
MN

Other

Enumeration date
09/28/2015
Last updated
09/28/2015
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