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General NPI Number Information
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NPI Number | 1851181630
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Entity Type | Individual
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Provider Name | WENDY ANDERSEN LMT
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 14332 21ST AVE N STE 200
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City | PLYMOUTH
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State | MN
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Zip | 55447-4566
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Country | US
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Telephone | 763-398-0365
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Fax |
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Provider Business Mailing Address
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Address Line | 245 14TH AVE N
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City | HOPKINS
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State | MN
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Zip | 55343-7331
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Country | US
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Telephone | 612-239-2189
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT2025003
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License Number State | MN
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