Individual
TERESA RENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 471-4070
(701) 471-4419
Mailing address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 471-4070
(701) 471-4419
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
808
ND
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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