| NPI | 1881319093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA LARSON Owner 320-293-3205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification |
| 225XG0600X Occupational Therapist, Gerontology | |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2023-01-19 |