Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 101790 | MN |
NPI | 1003929811 |
---|---|
Provider Name | Ann E. Richter |
First Address | Saint Paul, MN 55104-3898 |
Second Address | Saint Paul, MN 55104-3898 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 08/07/2007 |