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NPI Code Detail

MEDICARE: KRISTINE DESCHEPPER OTR/L

MEDICARE: KRISTINE DESCHEPPER 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
1225X00000XOccupational Therapist
2225X00000XOccupational Therapist104214MN

General Provider Information

NPI Number : 1831649664
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE DESCHEPPER OTR/L
Provider Business Mailing Address
First Line : 2101 WOODDALE DR STE A
Second Line :
City : WOODBURY
State : MN
Zip : 55125-2933
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 900 W 94TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55420-4206
Country : US
Telephone Number : 952-885-0418
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2016
Last Update Date : 11/10/2022

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Directions to “ KRISTINE DESCHEPPER OTR/L” Practice Location

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