Basic Information
| Provider Information | |||||||||
| NPI: | 1720054752 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OLSON | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | CHRIST | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L, CLT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15999 CRANE ST NW | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553044595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7634322728 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8290 UNIVERSITY AVE NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | FRIDLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554321847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637869543 | ||||||||
| FaxNumber: | 7637863320 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2006 | ||||||||
| LastUpdateDate: | 03/08/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | 102767 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
No ID Information.