Provider Demographics
NPI:1033341037
Name:REGENSCHEID, ANN (OT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:REGENSCHEID
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8617 EDINBROOK XING
Mailing Address - Street 2:#445
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-4016
Mailing Address - Country:US
Mailing Address - Phone:763-425-3169
Mailing Address - Fax:
Practice Address - Street 1:8617 EDINBROOK XING
Practice Address - Street 2:#445
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-4016
Practice Address - Country:US
Practice Address - Phone:763-425-3169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101752225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist