MEDICARE: LAURA PAGEL

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

General Provider Information

NPI Number	:	1932593753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA PAGEL

Provider Business Mailing Address
First Line	:	3917 W 31ST ST
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-4237
Country	:	US
Telephone Number	:	612-518-5346
Fax Number	:

Provider Business Practice Location Address
First Line	:	3917 W 31ST ST
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-4237
Country	:	US
Telephone Number	:	612-518-5346
Fax Number	:

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

Provider Enumeration Date	:	03/19/2015
Last Update Date	:	03/19/2015

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Directions to “ LAURA PAGEL ” Practice Location

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