Healthcare Provider Details

I. General information

NPI: 1033794474
Provider Name (Legal Business Name): REBECCA JO BINDER MARTURANO OTR/L.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1394 JACKSON ST
SAINT PAUL MN
55117-4629
US

IV. Provider business mailing address

31 W LAKE ST APT 1
CHISHOLM MN
55719-1816
US

V. Phone/Fax

Practice location:
  • Phone: 651-603-8774
  • Fax:
Mailing address:
  • Phone: 218-929-2873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number106470
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: