Individual
NICOLE HALVORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
622 ABERDEEN AVE, JORDAN, MN 55352-9516
(952) 492-5559
Mailing address
622 ABERDEEN AVE, JORDAN, MN 55352-9516
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104990
MN
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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