Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1488 | ND |
NPI | 1003363151 |
---|---|
Provider Name | Jessica Kaiser |
First Address | Bismarck, ND 58503-8534 |
Second Address | Bismarck, ND 58503-8534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2016 |
Last Update Date | 21/06/2021 |