Bakken, Lacey Jo
Bakken, Lacey Jo is an individual health care provider with primary practice located at 5225 23Rd Ave S , Fargo ND 58104-7927. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Bakken, Lacey Jo can be contacted via phone (701) 417-3400.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 1650 | North Dakota |
Profile Details
| NPI number | 1275193401 |
|---|---|
| LBN Legal business name | Bakken, Lacey Jo |
| Credentials | OTR/L |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 19th, 2019 |
| Last updated | Jun 19th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275193401 | NPPES |
| North Dakota | Other | 1650 | NDOTA |
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