Roots to Wings, LLC
NPI #1902173503 in Mendota Heights, Minnesota
Provider Information
- NPI Number
- 1902173503
- Entity Type
- Organization
- Organization Name
- Roots to Wings, LLC
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- Nov 27, 2011
- Last Updated
- Nov 27, 2011
Practice Location
- Address
- 2354 FIELD STONE CT
- City
- Mendota Heights
- State
- Minnesota
- ZIP Code
- 55120-1917
- Phone
- (651) 206-1034
Authorized Official
- Name
- JO ANNE TIERNEY, OTR/L
- Title
- OCCUPATIONAL THERAPIST, LICENSED
- Phone
- (651) 206-1034
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist |
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