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Individual

PEGGY J WASEMILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
275 11TH ST S, WAHPETON, ND 58075-4655
(701) 642-2000
(701) 671-4153
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 642-2000
(701) 671-4153

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
101442
MN
225X00000X
Occupational Therapist
Primary
301
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17856
NDBS #
ND
01
17907
NDBS #
ND
01
40R30WA
MNBS #
ND
01
42726
LHS #
ND
05
50334
ND
01
6401681
MEDICA #
ND
01
6405551
MEDICA #
ND
01
6405552
MEDICA #
ND
01
770674
AMERICA'S PPO/ARAZ #
ND
01
80520WA
MNBS #
ND
01
DA9011015523
PREFERRED ONE #
ND
01
DA9051015523
PREFERRED ONE #
ND
01
HP38649
HEALHTPARTNERS #
ND
Enumeration date
07/05/2006
Last updated
12/29/2011
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