Provider Demographics
NPI:1164570578
Name:DINGMANN, ROCHELLE ANN (OTRL)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:ANN
Last Name:DINGMANN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:ANN
Other - Last Name:KOCHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:547 QUEENS CT
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-6777
Mailing Address - Country:US
Mailing Address - Phone:218-287-2017
Mailing Address - Fax:701-232-2330
Practice Address - Street 1:921 43RD AVE N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-5320
Practice Address - Country:US
Practice Address - Phone:701-793-3646
Practice Address - Fax:701-232-2330
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND952225XP0200X
MN103216225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDHP53871OtherHEALTH PARTNERS PROV. #
ND370G3DIOtherEPNI PROVIDER NUMBER
MN370G3DIOtherBCBS MN PROVIDER NUMBER
ND25708OtherBCBS ND PROVIDER NUMBER
ND55077Medicaid