Healthcare Provider Details

I. General information

NPI: 1043028301
Provider Name (Legal Business Name): MILK & HONEY WELLNESS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 7TH AVE SW
MINOT ND
58701-3561
US

IV. Provider business mailing address

1905 7TH AVE SW
MINOT ND
58701-3561
US

V. Phone/Fax

Practice location:
  • Phone: 701-720-4638
  • Fax:
Mailing address:
  • Phone: 701-720-4638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PAIGE ERICKSON
Title or Position: OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 701-720-4638