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

Mia Rose Massaro

Individual provider Pediatric Occupational Therapist · NPI 1518525906

Mia Rose Massaro is a Pediatric Occupational Therapist in White Bear Lake, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2019

Practice location Address checks out

2555 County Road E E
White Bear Lake, MN 55110-4906
Phone: (651) 683-2953
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence 6028 (MN)

Record details

NPI number1518525906
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 31, 2019
Last updated in NPPESSeptember 26, 2023
Certification dateSeptember 26, 2023
Mailing address6776 Lake Dr Ste 220, Lino Lakes, MN 55014-1192

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