Individual
PATRICIA NEIDVIECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4575 23RD AVE S STE 400, FARGO, ND 58104-8783
(701) 347-1782
Mailing address
4575 23RD AVE S STE 400, FARGO, ND 58104-8783
(701) 347-1782
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1387
ND
Other
Enumeration date
12/29/2015
Last updated
03/10/2025
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