Individual
LADONNA BANNACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3244 51ST ST S, FARGO, ND 58104-7179
(701) 356-0062
(701) 356-5412
Mailing address
3244 51ST ST S, FARGO, ND 58104-7179
(701) 356-0062
(701) 356-5412
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
103366
MN
225X00000X
Occupational Therapist
Primary
792
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25625
NORIDIAN, BCBSND
ND
Enumeration date
10/19/2006
Last updated
04/30/2025
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