Individual
JOELLE DENISE ANDERSON
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) 417-3400
Mailing address
2319 WILLOW RD N, FARGO, ND 58102-2132
(701) 430-0201
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1594
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1594
—
ND
Enumeration date
06/13/2018
Last updated
06/13/2018
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