Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 104101 | MN |
Y | 225X00000X | Occupational Therapist | 1257 | ND |
NPI | 1003168444 |
---|---|
Provider Name | Ms. Kathleen Sayler |
First Address | Fargo, ND 58102-1620 |
Second Address | Fargo, ND 58104-5655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2012 |
Last Update Date | 24/03/2016 |