Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 101605 | MN |
NPI | 1134217367 |
---|---|
Provider Name | Maureen C Scanlan |
First Address | Eagan, MN 55121-2357 |
Second Address | Eagan, MN 55121-2357 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 29/08/2012 |