Doctor Name: | ALLISON V MIKOTA |
NPI Number: | 1104053198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OTR/L |
License Number: | 102368 |
Business Practice Address: | 1185 Town Centre Dr Ste 100 Eagan, MN - 551231188 |
Business Phone Number: | 6519685230 |
Business Fax Number: | 6519945200 |
Mailing Address: | 710 Commerce Dr Ste 200, WOODBURY |
State: | MN |
Postal Code: | 551254925 |
Phone Number: | 6519685042 |
Fax Number: | 6519685904 |
NPI Enumeration Date: | 06/17/2009 |
NPI Last Update Date: | 07/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225XH1200X |
License Number: | 102368 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Occupational Therapist |
Taxonomy Specialization: | Hand |
Taxonomy Definition: |