Individual
ALISHA GUMBLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-3400
Mailing address
5660 33RD AVE S APT 103, FARGO, ND 58104-7489
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1640
ND
Other
Enumeration date
09/09/2018
Last updated
09/09/2018
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