MEDICARE: MRS. JANET CASTERTON MOT OTRL

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
1	225XP0200X	Pediatric Occupational Therapist	OT14971	FL
2	225XP0200X	Pediatric Occupational Therapist	103527	MN

General Provider Information

NPI Number	:	1831263201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET CASTERTON MOT OTRL

Provider Business Mailing Address
First Line	:	6101 YORK AVE S
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55410-2831
Country	:	US
Telephone Number	:	616-822-2334
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 YORK AVE S
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55410-2831
Country	:	US
Telephone Number	:	616-822-2334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	01/25/2012

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