| Katie Stark, MOTR/L | |
|
2016 S Washington St, Grand Forks, ND 58201-6342 | |
| (701) 360-3305 | |
| Not Available |
| Full Name | Katie Stark |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist - Pediatrics |
| Location | 2016 S Washington St, Grand Forks, North Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265837991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XP0019X | Occupational Therapist - Physical Rehabilitation | 987 (North Dakota) | Secondary |
| 225XP0200X | Occupational Therapist - Pediatrics | 987 (North Dakota) | Primary |
| Provider Name | Life Skills And Transition Center |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1558427708 PECOS PAC ID: 7113986159 Enrollment ID: O20041006000563 |
| Mailing Address | Practice Location Address |
|---|---|
| Katie Stark, MOTR/L 1530 Western Ave, Grafton, ND 58237-2036 Ph: (701) 360-3305 | Katie Stark, MOTR/L 2016 S Washington St, Grand Forks, ND 58201-6342 Ph: (701) 360-3305 |
Mrs. Heather Ann Thibert, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1300 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-781-2300 Fax: 701-780-1942 | |
Alycia Ann Bosco, MOTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 2951 S 34th St, Grand Forks, ND 58201 Phone: 701-772-3851 | |
Heather Ann Audet, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-5000 | |
Stephanie Anne Suedel, MOTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 3535 S 31st St Ste 105, Grand Forks, ND 58201 Phone: 701-317-2897 Fax: 701-213-4345 | |
Stacie Lee Voth, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 South Columbia Road, Grand Forks, ND 58206 Phone: 701-780-5000 | |
Mrs. Rhonda Mae Roed, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 South Columbia Road, Grand Forks, ND 58206 Phone: 701-780-5340 Fax: 701-780-1942 | |
Mrs. Lacey Lynn Opperud Konickson, MOT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-5000 Fax: 701-780-1942 |