Healthcare Provider Details

I. General information

NPI: 1760302038
Provider Name (Legal Business Name): JILLIAN BECHTOLD OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 W INTERSTATE AVE
BISMARCK ND
58503-0964
US

IV. Provider business mailing address

809 W INTERSTATE AVE
BISMARCK ND
58503-0964
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-8538
  • Fax: 701-323-6900
Mailing address:
  • Phone: 701-323-6097
  • Fax: 701-323-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number2296
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: