Provider Demographics
NPI:1972849131
Name:PLADSON FRIE, LESLIE ANN (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:PLADSON FRIE
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ANN
Other - Last Name:PLADSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:2800 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6811
Mailing Address - Country:US
Mailing Address - Phone:701-365-8868
Mailing Address - Fax:701-365-8870
Practice Address - Street 1:2800 MAIN AVE
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6811
Practice Address - Country:US
Practice Address - Phone:701-365-8868
Practice Address - Fax:701-365-8870
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1276225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist