WANDA J LICKTEIG (NPI# 1104932730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104932730 |
| Entity Type | Individual |
| Full Name | WANDA J LICKTEIG |
| Credential | OTR/L, CHT |
| Practice Address |
1701 Curve Crest Blvd W Suite 104 Stillwater MN 55082-6044 |
| Mailing Address |
4200 Dahlberg Dr Suite 300 Golden Valley MN 55422-4840 |
| Practice Telephone | 6514398807 |
| Practice Fax Number | 6514390232 |
| Mailing Telephone | 9525125600 |
| Mailing Fax Number | 9525125651 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2016-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225XH1200X |
Occupational Therapist Specialization: Hand |
103078 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1701 CURVE CREST BLVD W SUITE 104 |
| City | STILLWATER |
| State | MN |
| Zip Code | 55082-6044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053381061 | Martin A Tahara | Dentist | 1701 Curve Crest Blvd W, Suite 108, Stillwater, MN 55082-6044 | 2006-01-23 |
| 1154864965 | Nicole Anne Sarauer | Clinical Nurse Specialist | 1701 Curve Crest Blvd W, Suite 104, Stillwater, MN 55082-6044 | 2016-11-28 |
| 1215315650 | Infinite Health Collaborative, Pa | Durable Medical Equipment & Medical Supplies | 1701 Curve Crest Blvd W, Suite 104, Stillwater, MN 55082-6044 | 2015-05-18 |
| 1578830790 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 1701 Curve Crest Blvd W, Ste. 104, Stillwater, MN 55082-6044 | 2011-11-17 |
| 1477692903 | Carissa Knutson | Dentist | 1701 Curve Crest Blvd W, Stillwater, MN 55082-6044 | 2007-02-05 |
| 1114065588 | Ned Windmiller | Dentist | 1701 Curve Crest Blvd W, Stillwater, MN 55082-6044 | 2007-02-01 |
| 1427129717 | St Croix Oral, Maxillofacial & Implant Surgery, P.a. | Dentist | 1701 Curve Crest Blvd W, Suite 108, Stillwater, MN 55082-6044 | 2006-11-10 |
| 1023088622 | Steven D Johnson | Dentist | 1701 Curve Crest Blvd W, Suite 108, Stillwater, MN 55082-6044 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| Find all providers in zip 55082 | ||||
| Taxonomy Code | 225XH1200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| Specialization | Hand |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205256484 | Eunjin Kim | Occupational Therapist | 3832 Hillsboro Ave N, New Hope, MN 55427-1613 | 2014-04-25 |
| 1326344912 | Gregory Lee Rife | Occupational Therapist | 10230 Baltimore St Ne, Blaine, MN 55449-4674 | 2011-01-31 |
| 1184817819 | Lynn Allison Hatfield | Occupational Therapist | 6515 Barrie Rd Ste 100, Edina, MN 55435-2305 | 2007-08-27 |
| 1720206618 | Patrice K. Schober-branigan | Occupational Therapist | 280 Smith Ave N Ste 100, Saint Paul, MN 55102-2424 | 2007-04-23 |
| 1457484917 | Corey Weston Mcgee | Occupational Therapist | 6363 France Ave. South, Suite 404, Edina, MN 55435 | 2007-03-13 |
| 1437225125 | Michelle Anne Reiner | Occupational Therapist | 2855 Campus Dr Ste 300, Plymouth, MN 55441 | 2006-11-27 |
| 1134217367 | Maureen C Scanlan | Occupational Therapist | 3294 Rolling Hills Dr, Eagan, MN 55121-2357 | 2006-10-11 |
| 1609964915 | Karolyn J Paulson | Occupational Therapist | 310 Smith Ave N Ste 360, Saint Paul, MN 55102-2383 | 2006-10-11 |
| 1649365628 | Aileen M Roberts | Occupational Therapist | 1425 Main St N, Pine City, MN 55063-6026 | 2006-10-04 |
| 1538254172 | Elizabeth Ann Mohror-hill | Occupational Therapist | 1500 Irving Street, Alexandria, MN 56308 | 2006-10-03 |
| Find all providers with the same taxonomy | ||||
| City | STILLWATER |
| Zip Code | 55082 |
Please comment or provide details below to improve the information on WANDA J LICKTEIG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.