Individual
JORDYN ALESE PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
683 STATE AVE, B, DICKINSON, ND 58601-4660
(701) 483-9400
Mailing address
1958 1ST ST W, DICKINSON, ND 58601-2426
(701) 640-9812
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1342
ND
Other
Enumeration date
10/07/2016
Last updated
12/03/2020
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