Individual
BETH A MAIRS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4201 25TH ST S, FARGO, ND 58104-6800
(701) 446-4300
Mailing address
4201 25TH ST S, FARGO, ND 58104-6800
(701) 446-4300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
386
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51583
—
ND
Enumeration date
03/06/2008
Last updated
03/06/2008
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