Engdahl, Alyssa
Engdahl, Alyssa is an individual health care provider with primary practice located at 5655 W 35Th St , St Louis Park MN 55416-2460. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Engdahl, Alyssa can be contacted via phone (612) 432-4091.Contact Information
Primary practice address
5655 W 35Th St
St Louis Park MN 55416-2460
Phone: (612) 432-4091
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 104949 | Minnesota |
Profile Details
| NPI number | 1659745156 |
|---|---|
| LBN Legal business name | Engdahl, Alyssa |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2015 |
| Last updated | Nov 20th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659745156 | NPPES |
| Minnesota | Other | 104949 | OT LICENSE |
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