Individual
NICOLETTE RONAYE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
218 POKEGAMA AVE N, GRAND RAPIDS, MN 55744
(218) 326-9453
(218) 326-9453
Mailing address
218 POKEGAMA AVE N, GRAND RAPIDS, MN 55744
(218) 326-9453
(218) 326-9453
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20050045
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20050045
AMMA
—
Enumeration date
01/17/2008
Last updated
06/21/2013
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