Individual
AMANDA JEAN VINGELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1300 S COLUMBIA RD, GRAND FORKS, ND 58201
(701) 780-5000
(701) 780-4477
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
(701) 780-4477
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
104259
MN
225X00000X
Occupational Therapist
Primary
1278
ND
225XP0019X
Physical Rehabilitation Occupational Therapist
104259
MN
Other
Enumeration date
06/20/2012
Last updated
06/26/2018
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