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General NPI Number Information
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NPI Number | 1356296438
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Entity Type | Individual
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Provider Name | SAMANTHA ERICKSON
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Gender | Female
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 2400 32ND AVE S
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City | FARGO
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State | ND
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Zip | 58103-5800
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Country | US
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Telephone | 701-234-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 4434 19TH ST S
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City | MOORHEAD
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State | MN
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Zip | 56560-3097
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2211
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License Number State | ND
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