Individual
MRS. NICOLE RIETZ HETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
11372302-4201
UT
225X00000X
Occupational Therapist
Primary
1220
SD
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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