Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 102056 | MN |
NPI | 1073618757 |
---|---|
Provider Name | Jennifer L Cole |
First Address | Eagan, MN 55122-5503 |
Second Address | Burnsville, MN 55337-6700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/07/2007 |