MEDICARE: ELIZABETH PERRA OTR/L, OTD

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	101901	MN

General Provider Information

NPI Number	:	1932037645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH PERRA OTR/L, OTD

Provider Business Mailing Address
First Line	:	3164 W OWASSO BLVD
Second Line	:
City	:	ROSEVILLE
State	:	MN
Zip	:	55113-2166
Country	:	US
Telephone Number	:	612-860-2430
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 LAKE VALENTINE RD
Second Line	:
City	:	ARDEN HILLS
State	:	MN
Zip	:	55112-2841
Country	:	US
Telephone Number	:	651-621-6000
Fax Number	:

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

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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