MISS Staci Rae Bleecker, COTA/L
NPI #1023556131 in Lisbon, North Dakota
Provider Information
- NPI Number
- 1023556131
- Entity Type
- Individual
- Name
- MISS Staci Rae Bleecker, COTA/L
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Occupational Therapy Assistant
- Credential
- COTA/L
- Enumeration Date
- Feb 9, 2017
- Last Updated
- Nov 12, 2019
Practice Location
- Address
- 905 MAIN ST
- City
- Lisbon
- State
- North Dakota
- ZIP Code
- 58054-4334
- Phone
- (701) 683-6402
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapy Assistant |
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