Individual
ALEXIS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
6046 14TH ST S, FARGO, ND 58104-7226
(701) 404-0997
(701) 566-8876
Mailing address
6046 14TH ST S, FARGO, ND 58104-7226
(701) 404-0997
(701) 566-8876
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
107839
MN
225X00000X
Occupational Therapist
Primary
2246
ND
225XM0800X
Mental Health Occupational Therapist
107839
MN
225XM0800X
Mental Health Occupational Therapist
2246
ND
Other
Enumeration date
10/20/2025
Last updated
12/17/2025
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