IndividualActive
Desiree Wildeman, OTR/L
NPI 1205100203 · Pediatric Occupational Therapist · Fargo, ND
Provider details
- NPI number
- 1205100203
- Entity type
- Individual
- Primary specialty
- Pediatric Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- No
- License
- 1221 (ND)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
3060 Frontier Way
Fargo, ND 58104-8909
Phone: (701) 232-2340
Fax: (701) 232-2330
Approximate (ZIP-level) locationGet directions
Mailing address
3060 Frontier Way
Fargo, ND 58104-8909
Registry dates
- Enumerated
- 2012-03-08
- Last updated
- 2012-03-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.