Miss Staci Rae Bleecker
Occupational Therapy Assistant
905 Main St
Lisbon
, North Dakota 58054-4334
Miss Staci Rae Bleecker
Occupational Therapy Assistant
905 Main St
Lisbon
, North Dakota 58054-4334
(701) 678-2244
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About
Features
Specialties
- Occupational Therapy Assistant
Languages spoken
- English
Location
First Address
- Miss Staci Rae Bleecker
- 11 N Main St
- Gwinner, ND
- Zip : 58040-4001
- Phone : (701) 678-2244
Second Address
- Miss Staci Rae Bleecker
- 905 Main St
- Lisbon, ND
- Zip : 58054-4334
- Phone : (701) 683-6402
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Is Miss Staci Rae Bleecker a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | 1260 | ND |
National Provider Identifier
| NPI | 1023556131 |
|---|---|
| Provider Name | Miss Staci Rae Bleecker |
| First Address | Gwinner, ND 58040-4001 |
| Second Address | Lisbon, ND 58054-4334 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/02/2017 |
| Last Update Date | 12/11/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.