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Individual

JULIE ANN NODSLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
803 ROOSEVELT AVE, # 301, DETROIT LAKES, MN 56501-3744
(218) 844-5555
(218) 844-6057
Mailing address
803 ROOSEVELT AVE, # 301, DETROIT LAKES, MN 56501-3744
(218) 844-5555
(218) 844-6057

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101251
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
073878600
MN
01
088S4N0
BLUE CROSS BLUE SHIELD
MN
01
29111
NORIDIAN
MN
Enumeration date
02/26/2007
Last updated
05/19/2009
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