Provider Demographics
NPI:1891844940
Name:RANCOUR, AIMEE LOUISE (COTA)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:LOUISE
Last Name:RANCOUR
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:LOUISE
Other - Last Name:BUBLITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:1095 HIGHWAY 15 S
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-5000
Mailing Address - Country:US
Mailing Address - Phone:230-234-5000
Mailing Address - Fax:
Practice Address - Street 1:1095 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-5000
Practice Address - Country:US
Practice Address - Phone:230-234-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN200193224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant