Healthcare Provider Details

I. General information

NPI: 1922270610
Provider Name (Legal Business Name): KAREN A. BISSON OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LEWIS AVE S STE# 210
WATERTOWN MN
55388-4545
US

IV. Provider business mailing address

200 LEWIS AVE S STE# 210
WATERTOWN MN
55388-4545
US

V. Phone/Fax

Practice location:
  • Phone: 952-955-2242
  • Fax: 952-955-2010
Mailing address:
  • Phone: 952-955-2242
  • Fax: 952-955-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number102336
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: