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General NPI Number Information
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NPI Number | 1679767644
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Entity Type | Individual
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Provider Name | MS. TRISTA LOUISE HOVE
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Gender | Female
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 1519 39TH AVE NE
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City | COLUMBIA HEIGHTS
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State | MN
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Zip | 55421-4014
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Country | US
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Telephone | 612-229-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 1519 39TH AVE NE
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City | COLUMBIA HEIGHTS
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State | MN
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Zip | 55421-4014
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Country | US
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Telephone | 612-229-5300
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 201368
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1589
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1974-027
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2156
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License Number State | NM
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