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General NPI Number Information
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NPI Number | 1255292850
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Entity Type | Organization
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Legal Business Name | BLOSSOMING ABILITIES PLLC
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 905 4TH ST N
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City | FARGO
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State | ND
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Zip | 58102-3748
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Country | US
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Telephone | 701-200-3038
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Fax |
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Provider Business Mailing Address
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Address Line | 905 4TH ST N
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City | FARGO
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State | ND
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Zip | 58102-3748
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Country | US
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Telephone | 701-200-3038
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | CARLIE DANIELLE RINAS
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Credential | MA, OTR/L, BCP
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Telephone | 701-200-3038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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