Gina Maria Frattalone Bigelbach, MAOTR/L

Individual provider Active NPI Occupational Therapist · Andover, MN

NPI 1124452206 · NPPES record last updated Aug 26, 2013

Key facts

NPI
1124452206
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
104270 (MN)
Practice address
1891 Station Pkwy NW
Andover, MN 55304-4259
Phone
(763) 755-4275
Fax
(763) 755-4261
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
104270MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Speech & Therapy Services, LLC Occupational Therapist Past
since Feb 8, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 104270 MN Yes

Addresses

Primary practice location

1891 Station Pkwy NW
Andover, MN 55304-4259

Mailing address

1891 Station Pkwy NW
Andover, MN 55304-4259

Other providers in Andover, MN

All providers in Andover, MN · Occupational Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.