Provider Demographics
NPI:1760256267
Name:AUSEN, MICHAEL (OTD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:AUSEN
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:
Other - First Name:MIKE
Other - Middle Name:
Other - Last Name:AUSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7906 CLAIBORNE LN
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-3040
Mailing Address - Country:US
Mailing Address - Phone:651-271-9475
Mailing Address - Fax:
Practice Address - Street 1:800 E 28TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3723
Practice Address - Country:US
Practice Address - Phone:612-863-6015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation