Healthcare Provider Details

I. General information

NPI: 1275447435
Provider Name (Legal Business Name): SIMPLAYFIED OCCUPATIONAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9074 JAREAU AVE S
COTTAGE GROVE MN
55016-4058
US

IV. Provider business mailing address

9074 JAREAU AVE S
COTTAGE GROVE MN
55016-4058
US

V. Phone/Fax

Practice location:
  • Phone: 218-453-8063
  • Fax: 218-453-8064
Mailing address:
  • Phone: 218-453-8063
  • Fax: 218-453-8064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHELSEY PETERS
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: OTR/L
Phone: 218-453-8063