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NPI Code Detail

MEDICARE: ABIGAIL MARIE ANDERSON OTD, OTR/L

MEDICARE: ABIGAIL MARIE ANDERSON 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 Therapist107324MN

General Provider Information

NPI Number : 1346002706
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL MARIE ANDERSON OTD, OTR/L
Provider Business Mailing Address
First Line : 4405 ALDRICH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55419-4821
Country : US
Telephone Number : 651-395-1800
Fax Number :
Provider Business Practice Location Address
First Line : 5500 94TH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55443-1992
Country : US
Telephone Number : 763-762-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2024
Last Update Date : 01/30/2024

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