Individual
NICOLE RENE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
500 N 5TH ST, HOT SPRINGS, SD 57747-1480
(605) 745-2000
Mailing address
500 N 5TH ST, HOT SPRINGS, SD 57747-1480
(605) 745-2000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1158
SD
225X00000X
Occupational Therapist
2374
NE
225X00000X
Occupational Therapist
OT.0005127
CO
Other
Enumeration date
08/20/2017
Last updated
04/27/2020
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