Provider Demographics
NPI:1386853802
Name:MEISSNER, ANNA LEE (MS,OTRL)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LEE
Last Name:MEISSNER
Suffix:
Gender:F
Credentials:MS,OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6681 56TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-5655
Mailing Address - Country:US
Mailing Address - Phone:701-361-9622
Mailing Address - Fax:701-540-0191
Practice Address - Street 1:6681 56TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-5655
Practice Address - Country:US
Practice Address - Phone:701-361-9622
Practice Address - Fax:701-540-0191
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103419225XP0200X
ND1008225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics