Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 106160 | MN |
NPI | 1003440371 |
---|---|
Provider Name | Samantha Marie Slinger |
First Address | Bloomington, MN 55438-2309 |
Second Address | St Louis Park, MN 55416-5275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2020 |
Last Update Date | 26/02/2020 |