Individual provider · Type 1 NPI

Mellissa Mary Moen, OTR

Occupational Therapist · St. Paul, MN

NPI number 1053652248 Active

Practice location

1824 Old Hudson Rd
St. Paul, MN 55119-4416

Call (763) 288-8208 Map

Mailing address

1219 Fallbrook Ln
Woodbury, MN 55125-9170

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000XNone listed

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1053652248

Mellissa Mary Moen, OTR's National Provider Identifier is 1053652248, issued on Mar 13, 2013. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in St. Paul, MN. The record was last updated on Apr 27, 2026.