Individual
MRS. LEAH S. HERMANSON-FAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
309 2ND ST E, BOTTINEAU, ND 58318-1104
(701) 228-3743
(701) 228-3365
Mailing address
309 2ND ST E, BOTTINEAU, ND 58318-1104
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
766
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52068
—
ND
Enumeration date
05/21/2007
Last updated
07/09/2007
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