| Wonderment Therapies | |
|
870 Pheasant Run Ave Dickinson ND 58601-6536 | |
| (701) 710-0800 | |
| Not Available |
| Full Name | Wonderment Therapies |
|---|---|
| Speciality | Behavior Analyst |
| Location | 870 Pheasant Run Ave, Dickinson, North Dakota |
| Authorized Official Name and Position | Jenna M Weisz (OWNER) |
| Authorized Official Contact | 7017653064 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wonderment Therapies Po Box 3201 Dickinson ND 58602-3201 Ph: (701) 765-3064 | Wonderment Therapies 870 Pheasant Run Ave Dickinson ND 58601-6536 Ph: (701) 710-0800 |
| NPI Number | 1376107557 |
|---|---|
| Provider Enumeration Date | 04/24/2019 |
| Last Update Date | 04/14/2021 |
| Certification Date | 04/14/2021 |
| Medicare PECOS PAC ID | 9830501675 |
|---|---|
| Medicare Enrollment ID | O20201218001734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376107557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| Provider Name | Jenna Weisz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205200359 PECOS PAC ID: 4183972300 Enrollment ID: I20180804000189 |
| Provider Name | Madison Jensen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467022400 PECOS PAC ID: 8426453507 Enrollment ID: I20210827001617 |
| Provider Name | Meghan Voigt |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1841864238 PECOS PAC ID: 3779951801 Enrollment ID: I20221122000829 |
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