Provider Demographics
NPI:1285839258
Name:FINLEY, JEAN LAVONNE (OTR L)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:LAVONNE
Last Name:FINLEY
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 EDGERTON STREET
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55117-1205
Mailing Address - Country:US
Mailing Address - Phone:651-490-1874
Mailing Address - Fax:651-490-1874
Practice Address - Street 1:2903 EDGERTON STREET
Practice Address - Street 2:
Practice Address - City:LITTLE CANADA
Practice Address - State:MN
Practice Address - Zip Code:55117-1205
Practice Address - Country:US
Practice Address - Phone:651-490-1874
Practice Address - Fax:651-490-1874
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100670225X00000X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8G213HEOtherBCBS
MN8G214F1OtherBCBS