Individual
SUSAN HARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16930 245TH AVE NW, BIG LAKE, MN 55309-9740
(763) 263-8094
Mailing address
16930 245TH AVE NW, BIG LAKE, MN 55309-9740
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100029
MN
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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