Individual
ALYSSA A SHIREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
102 W BEATON DR STE 105, WEST FARGO, ND 58078
(701) 261-4643
(701) 540-9044
Mailing address
3507 EVERGREEN RD N, FARGO, ND 58102-1218
(701) 261-4643
(701) 365-8134
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105100
MN
Other
Enumeration date
01/29/2018
Last updated
10/16/2018
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