Individual
MS. MARY SUSAN BAUMGARTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4372 52ND ST S, FARGO, ND 58104-4237
(701) 282-6622
Mailing address
4372 52ND ST S, FARGO, ND 58104-4237
(701) 282-6622
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
21
ND
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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