Individual
KAILEY WALCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1905 14TH ST W, WILLISTON, ND 58801-4063
(701) 651-6437
(701) 516-8462
Mailing address
1905 14TH ST W, WILLISTON, ND 58801-4063
(701) 651-6437
(701) 516-8462
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2043
ND
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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