Individual
NICOLE LEE IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
725 2ND AVE S, HOPKINS, MN 55343-7782
(952) 852-0620
Mailing address
666 CLEVELAND AVE SW, NEW BRIGHTON, MN 55112-3568
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202110
MN
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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