Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 103467 | MN |
Y | 225XH1200X | Occupational Therapist - Hand | 103467 | MN |
NPI | 1164614350 |
---|---|
Provider Name | Lilian Shun Ning Tang |
First Address | Saint Paul, MN 55102-2579 |
Second Address | Saint Paul, MN 55102-2579 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2007 |
Last Update Date | 03/04/2020 |