Individual
MS. INGRID SUSAN NILSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2299 METROPOLIS ST, METROPOLIS, IL 62960-1320
(618) 524-2634
Mailing address
2105 MADISON ST, PADUCAH, KY 42001-3144
(270) 575-1863
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31001703A
IN
225X00000X
Occupational Therapist
R1879
KY
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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