Provider Demographics
NPI:1568506897
Name:SCHULTZ, KARA ANN (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:ANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:ANN
Other - Last Name:DUDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, OTR/L
Mailing Address - Street 1:350 SAINT PETER ST
Mailing Address - Street 2:#1005
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1514
Mailing Address - Country:US
Mailing Address - Phone:218-310-4235
Mailing Address - Fax:
Practice Address - Street 1:2495 MAPLEWOOD DRIVE
Practice Address - Street 2:SUITE 313
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1913
Practice Address - Country:US
Practice Address - Phone:651-770-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102956225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics