Individual
LORI KERSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-8833
(701) 530-8842
Mailing address
900 E BROADWAY AVE, PO BOX 5510, BISMARCK, ND 58501-4520
(701) 530-8833
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
304
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
304
LICENSE
ND
Enumeration date
12/17/2009
Last updated
12/17/2009
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