MEDICARE: KATELYN FRAPPIER MOT OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	1436	ND

General Provider Information

NPI Number	:	1548630627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN FRAPPIER MOT OTR/L

Provider Business Mailing Address
First Line	:	3139 BLUESTEM DR STE 108
Second Line	:
City	:	WEST FARGO
State	:	ND
Zip	:	58078-8060
Country	:	US
Telephone Number	:	701-866-4934
Fax Number	:	701-718-9141

Provider Business Practice Location Address
First Line	:	3139 BLUESTEM DR STE 108
Second Line	:
City	:	WEST FARGO
State	:	ND
Zip	:	58078-8060
Country	:	US
Telephone Number	:	701-866-4934
Fax Number	:	701-718-9141

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2015
Last Update Date	:	12/08/2018

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