Individual
LISA VAN HEUKELOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
4530 NORTHERN SKY DR, BISMARCK, ND 58503-8534
(701) 751-6336
Mailing address
811 EASTVIEW DR, BISMARCK, ND 58501-3279
(701) 426-0755
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1538
ND
Other
Enumeration date
05/22/2017
Last updated
06/05/2023
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