Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand |
NPI | 1144992660 |
---|---|
Provider Name | Inna Alexeevna Tereshko |
First Address | Minneapolis, MN 55404 |
Second Address | Minneapolis, MN 55404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2021 |
Last Update Date | 03/10/2021 |