Provider Demographics
NPI:1245238658
Name:ERHARDT, RHODA P (MS, OTR/L, FAOTA)
Entity Type:Individual
Prefix:MRS
First Name:RHODA
Middle Name:P
Last Name:ERHARDT
Suffix:
Gender:F
Credentials:MS, OTR/L, FAOTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2379 SNOWSHOE CT E
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5645
Mailing Address - Country:US
Mailing Address - Phone:651-730-9004
Mailing Address - Fax:651-730-1939
Practice Address - Street 1:2379 SNOWSHOE CT E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55119-5645
Practice Address - Country:US
Practice Address - Phone:651-730-9004
Practice Address - Fax:651-730-1939
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100048225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN45403ERMedicare UPIN