MEDICARE: DAWN PAULSON OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	103709	MN

General Provider Information

NPI Number	:	1639494859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN PAULSON OTR/L

Provider Business Mailing Address
First Line	:	1120 KARTH LAKE DR
Second Line	:
City	:	ARDEN HILLS
State	:	MN
Zip	:	55112-5758
Country	:	US
Telephone Number	:	651-271-8393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 KARTH LAKE DR
Second Line	:
City	:	ARDEN HILLS
State	:	MN
Zip	:	55112-5758
Country	:	US
Telephone Number	:	651-271-8393
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2010
Last Update Date	:	02/27/2015

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