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NPI Code Detail

MEDICARE: EMILY MARY BICKNELL OTD, OTR/L

MEDICARE: EMILY MARY BICKNELL OTD, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist107830MN

General Provider Information

NPI Number : 1336039890
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY MARY BICKNELL OTD, OTR/L
Provider Business Mailing Address
First Line : 402 RED RIVER AVE N STE 5
Second Line :
City : COLD SPRING
State : MN
Zip : 56320-1523
Country : US
Telephone Number : 320-200-4473
Fax Number : 320-584-2660
Provider Business Practice Location Address
First Line : 402 RED RIVER AVE N
Second Line :
City : COLD SPRING
State : MN
Zip : 56320-1521
Country : US
Telephone Number : 320-200-4473
Fax Number : 320-584-2660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2025
Last Update Date : 07/07/2025

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