Healthcare Provider Details

I. General information

NPI: 1811092455
Provider Name (Legal Business Name): ROCHELLE LAVONNE LINDOW OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROCHELL LAVONNE WILLIAMS OT

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 CAMPUS DR SUITE 660
PLYMOUTH MN
55441-2649
US

IV. Provider business mailing address

4200 DAHLBERG DR SUITE 300
GOLDEN VALLEY MN
55422-4840
US

V. Phone/Fax

Practice location:
  • Phone: 763-520-7870
  • Fax: 763-520-7580
Mailing address:
  • Phone: 952-512-5600
  • Fax: 952-512-5651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number101067
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: