Individual
JANE ELISABETH AAFEDT MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTRL
Contact information
Practice address
3001 11TH ST. SO., FARGO, ND 58103-7417
(701) 356-0062
(701) 356-5412
Mailing address
3001 11TH ST. SO., FARGO, ND 58103-7417
(701) 356-0062
(701) 356-5412
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
103187
MN
225XP0200X
Pediatric Occupational Therapist
Primary
947
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27405
BCBS ND PROVIDER NUMBER
ND
05
—
55004
—
ND
Enumeration date
01/11/2007
Last updated
11/19/2012
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