Individual
JILL NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
1131 S MABELLE AVE, FERGUS FALLS, MN 56537-3723
(218) 998-1505
Mailing address
1131 S MABELLE AVE, FERGUS FALLS, MN 56537-3723
(218) 998-1505
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201473
MN
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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