Alyssa Noel Bagnall, MOT
Individual provider Active NPI Occupational Therapist · Maplewood, MN
NPI 1124454970 · NPPES record last updated Sep 24, 2013
Key facts
- NPI
- 1124454970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 104554 (MN)
- Practice address
- 2370 Stillwater Ave E Apt 303
Maplewood, MN 55119-3680 - Phone
- (641) 208-7033
- NPI assigned
- Sep 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104554 | MN | MD | Physical Medicine & Rehabilitation Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 104554 | MN | Yes |
Addresses
Primary practice location
2370 Stillwater Ave E Apt 303
Maplewood, MN 55119-3680
Mailing address
2370 Stillwater Ave E Apt 303
Maplewood, MN 55119-3680
Phone (641) 208-7033
Other providers in Maplewood, MN
- Autism Institute of Minnesota LLP
- Avalon Ramsey
- Sara M Avery-Babel
- Bagdade and Associates, LLC
- Paul S Bagdade
- Caroline Bailey
- Jawad Ahmad Bajwa
- Ann Marie Baker
- Keith Bakke
- Balsam Home Care Inc
All providers in Maplewood, MN · Occupational Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.