Elizabeth Laura Pouliot, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106997 Issued in MN

Practice address

538 Main St S
Cambridge, MN 55008-1614

Phone

(763) 260-3144

NPI assigned

Nov 8, 2022

Last updated

Nov 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Autism Opportunities Foundation

  dba MAC Midwest

  • Psychologist
  • Minnetonka, MN
  • NPI 1447348172
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1437867454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5384 383RD ST APT 309",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566198",
            "telephone_number": "763-260-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 MAIN ST S",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081614",
            "telephone_number": "763-260-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIOT",
        "first_name": "ELIZABETH",
        "middle_name": "LAURA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PHS/Cambridge Care Center, LLC
• Melissa Pierson, DDS
• Sandra Pliam
• Mark A Pocrnich, D.D.S.
• Tia Portillo
• David Clark Poulter, PT
• Michelle Powley, RN
• Mary Jane Preddy
• Michelle Lynn Preuss Varsoke, R.D., L.D.
• Timothy J Probst, MD

• Occupational Therapist in Cambridge, MN
• Providers in Cambridge, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.