Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1220 | ND |
NPI | 1003179920 |
---|---|
Provider Name | Luke Aaron Schlichenmayer |
First Address | Bismarck, ND 58501-4265 |
Second Address | Bismarck, ND 58503-0551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2012 |
Last Update Date | 18/06/2012 |