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Contact Information

MIRANDA MASSEY, OTR/L
14130 23RD AVE N
PLYMOUTH, MN55447
 Phone: 763-383-7666
 Fax: 763-383-6013
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MIRANDA MASSEY · (Female)

NPI # 1417643164
Status Active
Credentials OTR/L (Occupational Therapist, Registered, Licensed)
Entity Individual
Enumeration date 04/14/2023
Last updated 12/06/2023 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 107151
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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