Healthcare Provider Details

I. General information

NPI: 1992622013
Provider Name (Legal Business Name): RACHEL VIOLA HEXEM COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

683 STATE AVE STE B
DICKINSON ND
58601-4660
US

IV. Provider business mailing address

683 STATE AVE STE B
DICKINSON ND
58601-4660
US

V. Phone/Fax

Practice location:
  • Phone: 701-483-9400
  • Fax:
Mailing address:
  • Phone: 701-483-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number2303
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: