Provider Demographics
NPI:1881049906
Name:KAUPPI, ELIZABETH ANNA (MS OT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNA
Last Name:KAUPPI
Suffix:
Gender:F
Credentials:MS OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 CENTRAL AVE N
Mailing Address - Street 2:217
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 PLYMOUTH RD
Practice Address - Street 2:SUITE #220
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-2366
Practice Address - Country:US
Practice Address - Phone:952-223-2506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist