Provider Demographics
NPI:1689220501
Name:CONNOR, ANNA (OTD OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CONNOR
Suffix:
Gender:F
Credentials:OTD OTR/L
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:SIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD OTR/L
Mailing Address - Street 1:2101 WOODDALE DR STE A
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2933
Mailing Address - Country:US
Mailing Address - Phone:651-738-9888
Mailing Address - Fax:651-738-9889
Practice Address - Street 1:900 W 94TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-4206
Practice Address - Country:US
Practice Address - Phone:952-885-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2343225X00000X
MN106703225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist