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General NPI Number Information
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NPI Number | 1053933465
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Entity Type | Individual
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Provider Name | THERESE WHALEN DLUGOSCH OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 730 S 8TH STREET
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City | MINNEAPOLIS
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State | MN
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Zip | 55415
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Country | US
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Telephone | 612-873-2508
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 FREMONT AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55405-2639
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Country | US
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Telephone | 612-819-8212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 104530
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License Number State | MS
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