Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 103684 | MN |
NPI | 1003114190 |
---|---|
Provider Name | Mrs. Angela Rizo Rosales |
First Address | Minneapolis, MN 55418-4306 |
Second Address | West Saint Paul, MN 55118-3075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2011 |
Last Update Date | 01/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103684 | HEALTH OCCUPATIONS PROGRAM MINNESOTA DEPARTMENT OF HEALTH (01) | MN |
268870 | THE NATIONAL BOARD FOR CERTIFICATION IN OCCPATIONAL THERAPY, INC. (01) |