Basic Information
Provider Information
NPI: 1831124692
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NABER
FirstName: ALLISON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: O.T.R.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 820 ROY ST
Address2:  
City: ORTONVILLE
State: MN
PostalCode: 562781138
CountryCode: US
TelephoneNumber: 3208394271
FaxNumber: 3208394196
Practice Location
Address1: 1420 E COLLEGE DR STE 704
Address2:  
City: MARSHALL
State: MN
PostalCode: 562582065
CountryCode: US
TelephoneNumber: 5075323392
FaxNumber: 3208394196
Other Information
ProviderEnumerationDate: 07/11/2006
LastUpdateDate: 03/25/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X103138MNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
225X00000X0657SDN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home