Provider Demographics
NPI:1376515882
Name:FRIEDRICH, PATRICIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:FRIEDRICH
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 1:1140 MARDEN CIR
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:MN
Mailing Address - Zip Code:55352-8645
Mailing Address - Country:US
Mailing Address - Phone:952-758-5775
Mailing Address - Fax:952-758-5778
Practice Address - Street 1:314 MAIN ST E
Practice Address - Street 2:SUITE 3
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-2448
Practice Address - Country:US
Practice Address - Phone:952-758-5775
Practice Address - Fax:952-758-5778
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101786225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP43104OtherMN HEALTHPARTNERS NUMBER
MN685S6MCOtherMN BCBS NUMBER
MN7969234OtherMN AETNA NUMBER