Provider Demographics
NPI:1730649773
Name:BEERS, JANICE (COTA/L)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:BEERS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:BRETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2395 ARIEL ST N STE A
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2248
Mailing Address - Country:US
Mailing Address - Phone:651-288-0222
Mailing Address - Fax:651-288-0214
Practice Address - Street 1:2395 ARIEL ST N STE A
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2248
Practice Address - Country:US
Practice Address - Phone:651-288-0222
Practice Address - Fax:651-288-0214
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN200531224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant