Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 101106 | MN |
NPI | 1184761843 |
---|---|
Provider Name | Ms. Lynn Marie Wilbur |
First Address | Minneapolis, MN 55410-1344 |
Second Address | Bloomington, MN 55431-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 21/12/2021 |