Provider Demographics
NPI:1487831509
Name:JOUPPI, LOREN JADE (OTD)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:JADE
Last Name:JOUPPI
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55117-1781
Mailing Address - Country:US
Mailing Address - Phone:651-481-8040
Mailing Address - Fax:651-481-8649
Practice Address - Street 1:80 MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:LITTLE CANADA
Practice Address - State:MN
Practice Address - Zip Code:55117-1781
Practice Address - Country:US
Practice Address - Phone:651-481-8040
Practice Address - Fax:651-481-8649
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103539225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics