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General NPI Number Information
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NPI Number | 1639524507
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Entity Type | Individual
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Provider Name | HILLARY ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 8758 EGAN DR
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City | SAVAGE
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State | MN
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Zip | 55378-2561
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Country | US
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Telephone | 952-226-2999
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Fax | 952-443-9804
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Provider Business Mailing Address
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Address Line | 1772 STEIGER LAKE LN P.O.BOX 34
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City | VICTORIA
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State | MN
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Zip | 55386-7723
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Country | US
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Telephone | 952-443-9888
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Fax | 952-443-9804
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 105141
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License Number State | MN
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