Individual
MS. MADONNA A. MITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1702 E MAIN ST STE 103, MANDAN, ND 58554-3818
(701) 415-0000
(833) 969-0195
Mailing address
5500 94TH AVE N, BROOKLYN PARK, MN 55443-1992
(763) 762-6800
(763) 315-6685
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
929
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23089
BCBSND
ND
05
—
51326
—
ND
Enumeration date
05/30/2006
Last updated
06/15/2023
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