Provider Demographics
NPI:1558521757
Name:LOEN-BAKKE, SHERRY LYNAE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LYNAE
Last Name:LOEN-BAKKE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 130TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:FINLEY
Mailing Address - State:ND
Mailing Address - Zip Code:58230-9441
Mailing Address - Country:US
Mailing Address - Phone:701-789-1026
Mailing Address - Fax:701-524-1394
Practice Address - Street 1:652 130TH AVE NE
Practice Address - Street 2:
Practice Address - City:FINLEY
Practice Address - State:ND
Practice Address - Zip Code:58230-9441
Practice Address - Country:US
Practice Address - Phone:701-789-1026
Practice Address - Fax:701-524-1394
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND16225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist