Provider Demographics
NPI:1831124692
Name:NABER, ALLISON (OTR)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:NABER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 ROY ST
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56278-1138
Mailing Address - Country:US
Mailing Address - Phone:320-839-4271
Mailing Address - Fax:320-839-4196
Practice Address - Street 1:1420 E COLLEGE DR STE 704
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-2065
Practice Address - Country:US
Practice Address - Phone:507-532-3392
Practice Address - Fax:320-839-4196
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103138225X00000X
SD0657225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN670000434Medicare PIN
MN670000306Medicare PIN