Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 204 | ND |
NPI | 1063684801 |
---|---|
Provider Name | Sheila Allen Klosterman |
First Address | West Fargo, ND 58078-1817 |
Second Address | West Fargo, ND 58078-1817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 01/04/2008 |