Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 103746 | MN |
NPI | 1245468750 |
---|---|
Provider Name | Sally Nguyen |
First Address | Minneapolis, MN 55486-2901 |
Second Address | St Paul, MN 55102-2383 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 26/10/2009 |