Individual
MRS. MARY LYNN BERNTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL CHT
Contact information
Practice address
3035 DEMERS AVE, GRAND FORKS, ND 58201-4040
(701) 746-7521
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(701) 732-2947
(701) 732-2945
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
100966
MN
225X00000X
Occupational Therapist
Primary
25
ND
225X00000X
Occupational Therapist
AA522599
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1042277
PREFERRED ONE
—
01
—
201942600
MEDICAL ASSISTANCE
MN
01
—
24561
NORIDIAN MUTUAL
—
01
—
24780
DEMERS LOCATION
—
01
—
2605838
UNITED HEALTH CARE
—
01
—
341M0BE
BC/BS
MN
05
—
54901
—
ND
01
—
64-05705
MEDICA
—
01
—
HP62219
HEALTH PARTNERS
—
Enumeration date
01/19/2006
Last updated
07/01/2024
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