IndividualActive
Lisa Samuelson, OTR
NPI 1730669995 · Pediatric Occupational Therapist · Fargo, ND
Provider details
- NPI number
- 1730669995
- Entity type
- Individual
- Primary specialty
- Pediatric Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OTR
- Sex
- Female
- Sole proprietor
- Yes
- License
- 114432 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4342 15th Ave S Ste 105
Fargo, ND 58103-1125
Phone: (701) 936-9495
Fax: (952) 222-1994
Approximate (ZIP-level) locationGet directions
Mailing address
4342 15th Ave S Ste 105
Fargo, ND 58103-1125
Registry dates
- Enumerated
- 2018-08-17
- Last updated
- 2023-07-17
- Certified
- 2023-07-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.