Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 100698 | MN |
NPI | 1245349455 |
---|---|
Provider Name | Julie Ann Stauffer |
First Address | St Louis Park, MN 55426-1728 |
Second Address | Edina, MN 55435-2528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |