NPI 1063657120

Diane Jean McCormack, MSOTRL

Practitioner Pediatric Occupational Therapist Detroit Lakes, MN

Practice location

Address: 15840 Long Lake Road, Detroit Lakes, MN 56501
Phone: (218) 847-5071
Mailing address: P.O. Box 1382, Detroit Lakes, MN 56502

Registered specialties

Pediatric Occupational Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225XP0200X Licence 100296 (MN)

Other Occupational Therapist providers in Minnesota →

Registry record

NPI: 1063657120
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Dec 2008
Record last updated: 3 Dec 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.