Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 200742 | MN |
NPI | 1033278064 |
---|---|
Provider Name | Michelle A Valentini |
First Address | Stillwater, MN 55082-6070 |
Second Address | Stillwater, MN 55082-6070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |