Individual
KYLIE MELISSA WALTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2000
Mailing address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
440524
ND
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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