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Individual
NICOLE MARIE ANDERSON
Active
Individual
NICOLE MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, NCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305209126
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305209126
BOARD OF PHYSICAL THERAPY
VA
01
—
NE200038
NEUROLOGIC CERTIFIED SPECIALIST
—
Enumeration date
11/09/2022
Last updated
11/09/2022
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