Provider Demographics
NPI:1346568219
Name:WALOCH, BRITTNEY A (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:A
Last Name:WALOCH
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:A
Other - Last Name:MANSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:HANKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58041-0100
Mailing Address - Country:US
Mailing Address - Phone:701-242-7031
Mailing Address - Fax:701-242-8202
Practice Address - Street 1:102 6TH ST SE
Practice Address - Street 2:
Practice Address - City:HANKINSON
Practice Address - State:ND
Practice Address - Zip Code:58041-4200
Practice Address - Country:US
Practice Address - Phone:701-242-7031
Practice Address - Fax:701-242-8202
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1121225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics