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General NPI Number Information
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NPI Number | 1366564619
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Entity Type | Individual
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Provider Name | DAWN LYNN BECK COTAL
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16 SOUTH 8TH
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City | NEW ROCKFORD
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State | ND
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Zip | 58356-1520
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Country | US
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Telephone | 701-947-5015
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Fax | 701-947-5110
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Provider Business Mailing Address
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Address Line | PO BOX 486
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City | FESSENDEN
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State | ND
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Zip | 58438-0486
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Country | US
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Telephone | 701-547-3186
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 570
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License Number State | ND
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