Provider Demographics
NPI:1922577931
Name:OUSE GRINDBERG, ASHLYN JANE (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:ASHLYN
Middle Name:JANE
Last Name:OUSE GRINDBERG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:ASHLYN
Other - Middle Name:
Other - Last Name:GRINDBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:9300 30TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2305
Mailing Address - Country:US
Mailing Address - Phone:701-429-1714
Mailing Address - Fax:
Practice Address - Street 1:45 10TH ST W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1062
Practice Address - Country:US
Practice Address - Phone:701-429-1714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105746225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist