Individual
SUE TEMBROCK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2835 W SAINT GERMAIN ST, SUITE 300, SAINT CLOUD, MN 56301-4743
(320) 259-4151
(320) 259-5707
Mailing address
2835 W SAINT GERMAIN ST, SUITE 300, SAINT CLOUD, MN 56301-4743
(320) 259-4151
(320) 259-5707
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
MN100077
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149996
MAYO MANAGEMENT ID
MN
01
—
41163580956301B004
CHAMPUS
MN
01
—
6400074
MEDICA PROVIDER ID
MN
01
—
7G665TE
BCBS PROVIDER ID
MN
01
—
HP24516
HEALTHPARTNERS ID
MN
Enumeration date
11/29/2005
Last updated
07/08/2007
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