Healthcare Provider Details

I. General information

NPI: 1922303312
Provider Name (Legal Business Name): ANDREA MICHAL HOWELLS GREENHEART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2011
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 W BROADWAY AVE
MINNEAPOLIS MN
55411-2533
US

IV. Provider business mailing address

4348 11TH AVE S
MINNEAPOLIS MN
55407-3214
US

V. Phone/Fax

Practice location:
  • Phone: 612-668-0253
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number104008
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: