Individual
MS. AMY LYNN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2101
(309) 664-3420
Mailing address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009859
IL
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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