Provider Demographics
NPI:1093807430
Name:DANES, MARTHA (OTR)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:DANES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:
Other - Last Name:MUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13332 DANNER PATH
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-4372
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 SYNDICATE ST N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4107
Practice Address - Country:US
Practice Address - Phone:763-689-5385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102631225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP45722OtherHEALTH PARTNERS
MN018M1DAOtherBLUE CROSS BLUE SHIELD
MN6402266OtherMEDICA
MN018M1DAOtherBLUE CROSS BLUE SHIELD