Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 100288 | MN |
NPI | 1720392814 |
---|---|
Provider Name | Mrs. Margaret A Heinz |
First Address | Saint Paul, MN 55102-2311 |
Second Address | Saint Paul, MN 55102-2311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2010 |
Last Update Date | 30/07/2010 |