3001 Harbor Lane North, Suite 120, Plymouth, MN 55447
Phone
(651) 773-0354
Listed under
Pediatric occupational therapy
NPI
1063555373
NPI status
Active in the NPPES registry
Provider type
Individual provider
Registered specialty (self-reported taxonomy)
Occupational Therapist, Pediatrics (225XP0200X)
Credentials listed
MA, OTR/L
License number on NPI record
102823 (MN)
NPI first issued
Feb 15, 2007
NPI record last updated
Oct 25, 2019
NPI 1063555373 is active in the federal NPPES registry (CMS); license 102823 (MN) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-09-30.
What these registry facts mean
The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an individual clinician. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Pediatric occupational therapists help children with fine motor skills, self-care, sensory processing, handwriting and feeding.
Checking a license: the number above is what the provider entered in the NPI registry. Your state licensing board's lookup shows whether it is current. For individual therapists, ASHA (speech) and NBCOT (occupational therapy) let you verify national certification.