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General NPI Number Information
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NPI Number | 1245862564
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Entity Type | Individual
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Provider Name | ANDREA KATIJA STINOGEL OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 5868 BAKER RD
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City | MINNETONKA
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State | MN
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Zip | 55345-5903
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Country | US
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Telephone | 612-799-0925
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Fax |
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Provider Business Mailing Address
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Address Line | 102 E 19TH ST APT 309
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-3768
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Country | US
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Telephone |
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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 | 106119
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License Number State | MN
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