Individual
GRACE A NITSCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4141 31ST AVE S STE 104, FARGO, ND 58104-8778
(701) 353-1488
(213) 867-2798
Mailing address
4141 31ST AVE S STE 104, FARGO, ND 58104-8778
(701) 353-1488
(213) 867-2798
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
106707
MN
225X00000X
Occupational Therapist
Primary
1879
ND
225XM0800X
Mental Health Occupational Therapist
106707
MN
225XM0800X
Mental Health Occupational Therapist
1879
ND
Other
Enumeration date
06/24/2025
Last updated
10/21/2025
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