Individual
RIA EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2615 FAIRWAY ST, DICKINSON, ND 58601-2590
(701) 456-6000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 312-9802
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
822
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26897
BLUE CROSS OF NORTH DAKOT
ND
Enumeration date
09/28/2006
Last updated
05/10/2021
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