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NPI Code Detail

MEDICARE: WENDY M CAMP OTR/L, CHT

MEDICARE: WENDY M CAMP OTR/L, CHT
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 Therapist101142MN

General Provider Information

NPI Number : 1396851960
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY M CAMP OTR/L, CHT
Provider Business Mailing Address
First Line : 7581 9TH ST N
Second Line : SUITE 100
City : OAKDALE
State : MN
Zip : 55128-6626
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 146 LAKE ST N
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-2518
Country : US
Telephone Number : 651-464-8502
Fax Number : 651-464-8547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 09/08/2008

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