Individual
MEGAN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
415 4TH ST N, FARGO, ND 58102-4514
(701) 446-1000
Mailing address
6241 55TH AVE S, FARGO, ND 58104-5669
(701) 220-3884
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1291
ND
Other
Enumeration date
09/26/2014
Last updated
09/27/2016
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