Individual
DEB ODEGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
801 N BROADWAY, FARGO, ND 58122-4520
(701) 234-5608
Mailing address
801 N BROADWAY, FARGO, ND 58122-4520
(701) 234-5608
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
375
ND
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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