Provider Demographics
NPI:1669631636
Name:STRAND, CHARLANE MARTHA (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MS
First Name:CHARLANE
Middle Name:MARTHA
Last Name:STRAND
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:MISS
Other - First Name:CHARLANE
Other - Middle Name:MARTHA
Other - Last Name:MINOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICENSE OTR
Mailing Address - Street 1:10725 JAMES RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-4137
Mailing Address - Country:US
Mailing Address - Phone:952-884-5859
Mailing Address - Fax:
Practice Address - Street 1:333 SMITH AVE N
Practice Address - Street 2:UNITED HOSPITAL
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2344
Practice Address - Country:US
Practice Address - Phone:651-241-8565
Practice Address - Fax:651-241-7117
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100584225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist