Individual
NICOLE RAUTERKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2595
(801) 673-9649
Mailing address
1007 CALLE SOMBRA STE A, SAN CLEMENTE, CA 92673-6244
(949) 272-6146
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/01/2020
Last updated
05/11/2023
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