Individual
ELIESA WOGGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
559 CAPITOL BLVD, SAINT PAUL, MN 55103-2101
(651) 232-2660
Mailing address
559 CAPITOL BLVD, SAINT PAUL, MN 55103-2101
(651) 232-2660
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105158
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105158
OCCUPATIONAL THERAPIST PRACTITIONER LICENSE
MN
Enumeration date
03/01/2019
Last updated
03/01/2019
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