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General NPI Number Information
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NPI Number | 1255112363
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Entity Type | Individual
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Provider Name | ALLISON A ROEHL OTD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 10653 WAYZATA BLVD
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City | MINNETONKA
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State | MN
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Zip | 55305-1528
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Country | US
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Telephone | 952-224-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 1902 SAPPHIRE PT
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City | EAGAN
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State | MN
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Zip | 55122-8802
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Country | US
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Telephone | 320-444-6085
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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 | 6034
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License Number State | MN
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