Individual
ALLEXIS TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6681 56TH AVE S, FARGO, ND 58104-5655
(701) 212-1215
(701) 540-0191
Mailing address
6681 56TH AVE S, FARGO, ND 58104-5655
(701) 212-1215
(701) 540-0191
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1993
ND
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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