Provider Demographics
NPI:1154422772
Name:DICK, JAIME (OTR)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:DICK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:
Other - Last Name:OCHOWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2482 540TH ST
Mailing Address - Street 2:
Mailing Address - City:BRAHAM
Mailing Address - State:MN
Mailing Address - Zip Code:55006-3645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 HIGHWAY 95 E STE 190
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1769
Practice Address - Country:US
Practice Address - Phone:763-689-5385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102533225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN54D660COtherBLUE CROSS BLUE SHIELD
MNHP45728OtherHEALTH PARTNERS
MN6404186OtherMEDICA
MN54D660COtherBLUE CROSS BLUE SHIELD