Individual
MRS. NICOLE MARIAH JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. OTR/L
Contact information
Practice address
505 KANSAS CITY ST STE 3, RAPID CITY, SD 57701-3673
(605) 222-7336
(605) 791-0631
Mailing address
505 KANSAS CITY ST STE 3, RAPID CITY, SD 57701-3673
(605) 222-7336
(605) 791-0631
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1093
SD
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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