Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 105103 | MN |
NPI | 1013467984 |
---|---|
Provider Name | Maggie Caroline Mccabe |
First Address | Maplewood, MN 55109-2202 |
Second Address | Maplewood, MN 55109-2202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2016 |
Last Update Date | 04/10/2016 |