Healthcare Provider Details

I. General information

NPI: 1497423594
Provider Name (Legal Business Name): SYDNI RABAEY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2021
Last Update Date: 09/02/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W 66TH ST STE 300
EDINA MN
55435-2110
US

IV. Provider business mailing address

3520 W 32ND ST APT 104
MINNEAPOLIS MN
55416-4523
US

V. Phone/Fax

Practice location:
  • Phone: 651-406-8868
  • Fax:
Mailing address:
  • Phone: 763-218-1339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number106477
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number106477
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number106477
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: