IndividualActive
Patricia Neidviecky, COTA/L
NPI 1114382587 · Occupational Therapy Assistant · Fargo, ND
Provider details
- NPI number
- 1114382587
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- No
- License
- 1387 (ND)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4575 23rd Ave S Ste 400
Fargo, ND 58104-8783
Phone: (701) 347-1782
Approximate (ZIP-level) locationGet directions
Mailing address
4575 23rd Ave S Ste 400
Fargo, ND 58104-8783
Registry dates
- Enumerated
- 2015-12-29
- Last updated
- 2025-03-10
- Certified
- 2025-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.