Individual
NICOLE M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
815 FOREST AVE, NORTHFIELD, MN 55057-1643
(507) 664-8800
Mailing address
2417 PEPPER RIDGE CT, NORTHFIELD, MN 55057-3257
(612) 203-6293
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104787
MN
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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