Individual
LAURA LEE NYQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-5411
Mailing address
1461 W MAIN ST STE F, WHITEWATER, WI 53190-1568
(262) 473-5599
(262) 473-8522
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2800-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41031300
—
WI
Enumeration date
07/28/2006
Last updated
05/30/2019
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