Andrew Michael Aeshliman, COTA

Individual provider Active NPI Occupational Therapy Assistant · St Louis Park, MN

NPI 1306609102 · NPPES record last updated Feb 5, 2024

Key facts

NPI
1306609102
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
202354 (MN)
Practice address
5320 W 23Rd St Ste 130
St Louis Park, MN 55416-1670
Phone
(952) 345-8770
NPI assigned
Feb 5, 2024
Sex
Male
Sole proprietor
No

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
202354MNMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 202354 MN Yes

Addresses

Primary practice location

5320 W 23Rd St Ste 130
St Louis Park, MN 55416-1670

Mailing address

758 New Century Blvd S
Maplewood, MN 55119-5996

Other providers in St Louis Park, MN

All providers in St Louis Park, MN · Occupational Therapy Assistant in Minnesota

Sources for this page

Verify at the official NPI Registry.