Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Allysan L Mickle, OTR/L

Individual provider Occupational Therapist · NPI 1043132111

Allysan L Mickle, OTR/L is an Occupational Therapist in Moose Lake, Minnesota. Licensed in Minnesota. Registered with an NPI since 2026.

Licensed in
MN
In the registry since
2026
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

4572 County Road 61
Moose Lake, MN 55767-9401
Phone: (218) 485-4481
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 108128 (MN)

Record details

NPI number1043132111
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedJuly 29, 2026
Last updated in NPPESJuly 29, 2026
Certification dateJuly 29, 2026

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