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Individual

DIANE ANDERSON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
200 OAK STREET S.E. MCNAMARA ALUMNI CENTER, SUITE 160 UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-5645
Mailing address
420 DELAWARE STREET SE, MMC 388 UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 625-2661
(612) 624-6686

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101023
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1029526
PREFERRED ONE
MN
01
2388748
ARAZ
MN
05
3401887
MT
05
40897100
WI
01
64-05886
MEDICA CHOICE & PRIMARY
MN
01
700T9AN
BCBS
MN
01
B677
CHAMPUS/TRIWEST
MN
01
HP56993
HEALTHPARTNERS
MN
Enumeration date
06/16/2006
Last updated
07/09/2007
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